Diagnosis and management of melanocytic skin lesion in the pediatric praxis: A review of the literature

Children may present a variable spectrum of melanocytic skin lesions and the great majority of them is benign. Childhood melanoma is still exceptionally rare, although recent data suggest an increasing incidence even in young age. The optimal management of children presenting with melanocytic skin lesions aims therefore to a twofold goal, that is to reduce unnecessary surgical excisions of benign melanocytic nevi without running the risk to miss melanoma. Dermoscopy is an in vivo, noninvasive optical tool that aids to approaching this goal. It comes therefore not as a surprise that dermoscopy has gained popularity for the diagnosis and management of pigmented and nonpigmented skin lesions in the pediatric praxis. In this article, we provide a review of the current literature on dermoscopy patterns of melanocytic skin lesions and their management with special emphasis to a pediatric population. Moreover, we discuss recent concepts regarding nevogenesis and highlight some controversial aspects regarding childhood melanoma.