Melanocytic skin lesions in children: Dermoscopy patterns and management considerations

Children may present a large spectrum of melanocytic skin lesions, of those the great majority are benign nevi, while childhood melanoma is exceptionally rare. However, due to this and other reasons, the diagnosis of childhood melanoma is often delayed. The optimal management of children presenting with melanocytic skin lesions aims therefore at a two-fold goal: first, to reduce surgical excisions of benign melanocytic nevi, and second, to improve the early diagnosis of melanoma. Dermoscopy has been shown to reach this goal, which explains the increasing use of this noninvasive technique for the daily management of patients with pigmented and nonpigmented skin lesions. Supplementary digital dermoscopic follow-up allows the observation of dynamic changes over time, which improves not only the early diagnosis of melanoma, but allows new insights into the natural evolution of melanocytic nevi. In this article, we reviewed the current literature on the dermoscopy patterns of melanocytic skin lesions in childhood and considerations on their management as well as on new concepts of nevogenesis and ongoing controversies regarding childhood melanoma.