RT Book, Section
A1 Pan, Brian S.
A1 Billmire, David A.
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100439875
T1 Pigmented Lesions and Melanoma
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesssurgery.mhmedical.com/content.aspx?aid=1100439875
RD 2024/04/16
AB Ninety-eight  percent  of  Caucasian  children  have  at  least  1  nevus  by  early  childhood.  In  contrast,  melanoma  accounts  for  only  2%  of  all  pediatric  malignancies.Physical  features  that  may  raise  suspicion  for  malignant  transformation  include  asymmetry,  irregularity  of  the  borders,  variability  in  the  color,  and  diameter  greater  than  5  mm  (ABCD  criteria).A  Spitz  nevus  in  its  typical  form  is  a  benign  melanocytic  lesion  that  is  a  diagnostic  and  management  challenge  for  both  pathologists  and  clinicians  secondary  to  the  histologic  features  it  can  potentially  share  with  melanoma.The  nevus  sebaceous  of  Jadassohn  is  a  benign  epidermal  nevus  most  commonly  encountered  on  the  scalp  and  face  with  a  reported  incidence  of  basal  cell  carcinoma  of  0.8%.Giant  congenital  nevi  carry  a  lifetime  malignancy  risk  ranging  from  2.8  to  8.5%  and  60%  of  these  malignancies  occurred  within  the  first  decade  of  life.Melanomas  less  than  1-mm  thick  should  be  excised  with  a  1-cm  margin  while  for  those  greater  than  1  mm  in  thickness,  a  2-cm  margin  is  acceptable.Surgical  treatment  options  for  large  pigmented  lesions  include  serial  excision,  skin  grafting,  and  tissue  expansion.