ABSTRACT
Pigmented lesions represent a common congenital diagnosis
encountered by the pediatric surgeon. Congenital nevi repre-
sent a group of skin lesions occurring at birth or becoming
apparent within the first few years of life, and are character-
ized by ectopic rests of dermal elements. Although most
commonly melanocytic in nature (such as the congenital
melanocytic nevus, nevi of Ota, nevi of Ito, nevus spilus,
cafe´-au-lait spots, and Mongolian spots), nevi can also
originate from sebaceous (nevus sebaceous of Jadassohn),
neural or epidermal elements. Lesion characteristics vary
according to the type of cell involved, location within the
skin, and level of cell differentiation. Knowledge of the
differential diagnosis and natural history of these lesions can
help balance the plan of care, so as to address the potential
risk of malignant degeneration while accounting for func-
tional and esthetic concerns encountered during excision and
reconstruction.
