What are the other Names for this Condition? (Also known as/Synonyms)

• Atypical Proliferative Nodules in Giant Congenital Naevi
• Dermal Cystic Tumor of Uncertain Potential in a Giant Congenital Nevus
• Dermal Variant of Minimal Deviation Melanoma in a Giant Congenital Naevus

What is Proliferative Nodules in Congenital Melanocytic Nevi? (Definition/Background Information)

• A nevus (plural nevi) is a mole on the skin that can occur on any part of the body. A melanocytic nevus is benign tumor of melanocytic (pigment-based) cells that occur on the skin
• A congenital melanocytic nevus (CMN) is a common melanocytic mole that is present at birth, on the skin of the baby. It may be present anywhere on the body
• Congenital melanocytic nevi (CMN) are categorized by size as small, medium, large, and giant. Small lesions are by far the most commonly noted CMNs
• Proliferative Nodules in Congenital Melanocytic Nevi are mostly observed in the period immediately following the birth of the child. The condition is manifested as numerous small nodules around a preexisting giant congenital nevus, which can  cover large portions of the child’s body
• The condition is present as nodules or plaques on the skin. The cause of Proliferative Nodules in Congenital Melanocytic Nevi is generally unknown. Research studies have identified certain chromosomal aberrations in some of the cases
• A biopsy is necessary to make the diagnosis of Proliferative Nodules in Congenital Nevus, and distinguish it from malignant melanoma
• Treatment is generally not required for Proliferative Nodules in Congenital Melanocytic Nevi unless it presents cosmetic issues. The prognosis is generally excellent with or without treatment, since these moles are typically benign

Who gets Proliferative Nodules in Congenital Melanocytic Nevi? (Age and Sex Distribution)

• Proliferative Nodules in Congenital Melanocytic Nevi are manifested in newborn children (congenital in nature); they are primarily observed in the neonatal period
• Both males and females are affected and there is no gender bias noted
• All racial and ethnic groups are at risk and no particular predilection is noted

What are the Risk Factors for Proliferative Nodules in Congenital Melanocytic Nevi? (Predisposing Factors)

• No risk factors for Proliferative Nodules in Congenital Melanocytic Nevi have been currently identified

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Proliferative Nodules in Congenital Melanocytic Nevi? (Etiology)

• The cause of formation of Proliferative Nodules in Congenital Melanocytic Nevi is unknown in a majority of cases
• However, chromosomal abnormalities have been documented in some cases

What are the Signs and Symptoms of Proliferative Nodules in Congenital Melanocytic Nevi?

The signs and symptoms of Proliferative Nodules in Congenital Melanocytic Nevi that may be observed include:

• Benign proliferation of melanocytic cells (nevi) on the skin that form small nodules
• The proliferation may consist of nodules or plaques (broad, raised areas on the skin)
• The proliferative nodules are usually present above the melanocytic nevus (giant congenital nevus)
• The giant melanocytic nevus may occasionally be ‘deep’ in the skin and present as a palpable mass
• The benign nevi or moles are usually pigmented. The color may vary from dark brown to black
• The proliferative nodules can occur all over the body; in some, large portions of the body area may be covered (or appear pigmented)
• With time, the dark nevi may take on lighter shades and recede

How is Proliferative Nodules in Congenital Melanocytic Nevi Diagnosed?

Proliferative Nodules in Congenital Melanocytic Nevi are diagnosed through the following tools:

• Complete physical examination with evaluation of medical history
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Genetic testing of the biopsy material may be done to differentiate the condition from melanoma

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Proliferative Nodules in Congenital Melanocytic Nevi?

There are frequently no complications that arise from a Proliferative Nodules in Congenital Melanocytic Nevi.

• Nevertheless, in some children, it may present cosmetic concerns as large areas of the skin may be involved
• Scratching or itching of the moles may lead to bleeding and ulceration. This can cause secondary bacterial or fungal infections to develop
• In some cases, malignant melanomas have been associated with congenital melanocytic nevi

How is Proliferative Nodules in Congenital Melanocytic Nevi Treated?

The treatment measures for Proliferative Nodules in Congenital Melanocytic Nevi may include:

• The healthcare provider may choose to regularly observe the condition, to check for any atypical features (a “wait and watch” approach may be followed), with clinical photography for more detailed comparison
• Surgical excision and removal, if necessary for cosmetic reasons

How can Proliferative Nodules in Congenital Melanocytic Nevi be Prevented?

Current medical research has not established a method of preventing the occurrence of Proliferative Nodules in Congenital Melanocytic Nevi.

What is the Prognosis of Proliferative Nodules in Congenital Melanocytic Nevi (Outcomes/Resolutions)

• The prognosis of Proliferative Nodules in Congenital Melanocytic Nevi is excellent on its complete excision and removal
• Since, these are benign conditions, the prognosis is excellent even if no treatment is provided and only periodic observation maintained

Additional and Relevant Useful Information for Proliferative Nodules in Congenital Melanocytic Nevi:

• Do not pick or scratch the moles
• It is important to note that a congenital melanocytic nevus does not become a melanoma with scratching, itching, or trauma. However, these should be avoided since bleeding and ulceration of skin may cause superimposed infections
• If a mole is present at birth, it is referred to as a congenital mole. If they occur in the first 2 years of life, some healthcare providers call them congenital-type moles