About child naevus

What is child naevus?

CHILD syndrome (an acronym for congenital hemidysplasia with ichthyosiform erythroderma and limb defects) is an inherited disorder, affecting primarily women, that is characterized by ichthyosis-like skin abnormalities and limb defects on one side of the body. Other abnormalities may be present, as well.

If defects of other body organs are present, they are usually on the same side of the body as the skin and limb abnormalities.



What are the symptoms for child naevus?

There are several types of congenital nevi, depending on their size and appearance.

Large or giant

Nevi grow as your body grows. A nevus that will grow to an adult size of 8 inches or more across is considered a giant nevus.

On a newborn child, this means that a nevus that measures 2 inches across is considered a giant one. However, because the head grows somewhat less than the rest of the body, a nevus that measures 3 inches across on the head of a newborn is also classified as giant.

Giant nevi are relatively rare, occurring in roughly 1 out of 20,000 live births.

A doctor might classify a congenital nevus as large if it:

  • is larger than the palm of the child’s hand
  • is not removable by a single surgical cut
  • covers a large part of the head, legs, or arms

They may classify a congenital nevus as giant if it:

  • covers a very large part of the body
  • involves much of the torso
  • is accompanied by many smaller (satellite) nevi

Small and medium congenital nevi

A congenital nevus that measures less than 1.5 centimeters (cm) across (about 5/8 inch) is classified as small. These are fairly common, occurring in about 1 in every 100 newborn children.

A nevus that’s expected to grow to an adult size of 1.5 to 19.9 cm across (5/8 to 7 3/4 inches) is classified as medium. Medium nevi occur in about 1 in every 1,000 newborns.

Other types

Other types of congenital nevi include:

  • speckled lentiginous nevus, which has dark spots on a flat, tan background
  • satellite lesions, which are smaller moles, either surrounding the main nevus or located somewhere else on the body
  • tardive nevus, which is a nevus that appears after birth, usually before age 2, and grows slowly
  • garment nevus, which refers to a nevus either around the buttocks or on the entire arm or shoulder
  • halo nevus, which is a mole with light- or white-colored skin surrounding it



What are the causes for child naevus?

Researchers aren’t sure about the exact causes of congenital nevi. However, they do know that they start to grow between 5 and 24 weeks. The earlier they start growing, the larger they usually are at birth.



What are the treatments for child naevus?

In most cases, congenital nevi don’t cause any physical problems and don’t require treatment. However, they can make some people self-conscious.

It’s hard to surgically remove congenital nevi, especially large and giant ones. These may require several cuts, stitches, or even skin replacement. All of this can result in scarring that some people find more bothersome than the mole itself.

Your doctor can give you a better idea of whether surgery will work based on the size and type of nevus.

Some alternatives to surgery include:

  • Dermabrasion. This treatment uses a wire brush or diamond wheel to remove layers of skin. While it won’t completely remove a congenital nevus, it can lighten its appearance. However, it can also leave scarring. Dermabrasion is most effective when done in the first six weeks of life.
  • Skin curettage. This involves scraping away the top layers of skin. Like dermabrasion it is best performed in the first six weeks of life.
  • Tangential excision. The top layers of skin are removed using a blade. Like other options, it won’t remove the nevus completely, and it may leave scarring. However, it can make the nevus less noticeable.
  • Chemical peels. These may help to improve the appearance of lighter-colored nevi. Phenol and trichloroacetic acid are common chemicals used in peels.

While most congenital nevi are harmless, they can occasionally become cancerous. Giant congenital nevi carry the highest risk. Keep in mind that surgery isn’t a guarantee against cancer. Fifty percent of melanomas found in people with giant congenital nevi occur elsewhere on the body. In addition, the estimated lifetime risk of melanoma for a person born with a giant nevus varies from 5 to 10 percent.

Medium and large nevi may also have a higher risk of becoming cancerous.

Anyone born with a large, giant, or even medium congenital nevus should get regular skin exams. Make sure to tell your doctor if you notice any of the following:

  • darkening of the nevus
  • lumpiness
  • increase in size
  • irregular shape
  • changes in color

Neurocutaneous melanocytosis is another possible complication of giant congenital nevi. This condition involves the presence of melanocytes in the brain and spinal cord. It affects an estimated 5 to 10 percent of people with giant congenital nevus. In many cases, it doesn’t have any symptoms, but it may occasionally cause:

  • headaches
  • vomiting
  • irritability
  • seizures
  • developmental issues



What are the risk factors for child naevus?

Only about 30 cases have been reported in the United States and of these 29 involved infant girls and only 1 involved a boy. Of these 30 cases, only 6 cases involved organs or systems on the left side of the body.



Is there a cure/medications for child naevus?

Congenital or Child Naevus (moles) generally don't cause problems unless they show cancerous signs.

Cure/medications include:

  • Your child's doctor will need to check the mole over time to watch for any changes that may signal a future risk of skin cancer.
  • On the other hand, if you worry about the mole's appearance or location, you can talk to your doctor about removal.
  • Discussing with the doctor/surgeon about the options can be the best way to proceed.
  • On a surgery basis, the mole will be removed using a scalpel.
  • If the mole is very large, it may not be possible for the surgeons to remove it all in one step. They may take a few smaller steps (staged excision) to reduce its size and make future complete removal easier.
  • A doctor may use a tissue expander for young children with very large moles to grow new skin that can replace tissue removed with the mole.
  • Please note that surgeries may leave scars, which need to be considered.


Approaches alternative to surgery include:

  • Dermabrasion, a treatment that uses a wire brush or diamond wheel to remove layers of skin. Although this treatment won't remove the mole and will only help lighten the appearance. It can also leave scarring.
  • Chemical peels may help to improve the appearance of lighter-colored nevi. Phenol and trichloroacetic acid are common chemicals used in peels.


Symptoms
A round or oval-shaped patch of colored skin,Might have hair growing out of them,Occasionally itchy when they're larger,Fragile skin
Conditions
A round or oval-shaped patch of colored skin
Drugs
Surgery,Chemical peel,Dermabrasion,Skin curettage,Tangential excision



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