ABSTRACT

Congenital cutaneous lesions are common presenting problems in the practice of pediatric surgery. The pigmented lesions can be subdivided easily into those of vascular origin vs those of melanocytic and dermal origin. Commonly these latter lesions are termed ‘moles’ or ‘nevi.’ Although the bulk of these lesions are small and benign, some cover large portions of the body or can be in conspicuous locations presenting challenging reconstructive problems. Furthermore, their potential for malignant degeneration causes anxiety for the parent, primary care physician and surgeon alike. The goal of this chapter is to classify the more common cutaneous lesions, review the pathophysiology and natural history, summarize the risk of malignant degeneration and provide a rational approach to treatment. Indications for complex reconstructive procedures and novel techniques will also be discussed.