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Journal of the American Academy of Dermatology
Volume 61, n° 5
pages 766-774 (novembre 2009)
Doi : 10.1016/j.jaad.2008.11.022
accepted : 11 November 2008
Original Articles

Large congenital melanocytic nevi and neurocutaneous melanocytosis: One pediatric center’s experience
 

Audrey Lovett, MD, FRCPC a, Catherine Maari, MD, FRCPC a, , Jean-Claude Decarie, MD, FRCPC b, Danielle Marcoux, MD, FRCPC a, Catherine McCuaig, MD, FRCPC a, Afshin Hatami, MD, FRCPC a, Pascal Savard, MD, FRCPC a, Julie Powell, MD, FRCPC a
a Dermatology Service, Department of Pediatrics, Sainte-Justine Hospital Center, Montreal, Quebec, Canada 
b Department of Radiology, Sainte-Justine Hospital Center, Montreal, Quebec, Canada 

Reprint requests: Catherine Maari, MD, FRCPC, Division of Pediatric Dermatology, Ste-Justine Hospital, 3175, chemin Cote Ste-Catherine, Montreal, Quebec, Canada. H3T 1C5.
Abstract
Background

Large congenital melanocytic nevi (LCMN) predispose to neurocutaneous melanocytosis (NCM), which is associated with significant morbidity and mortality.

Objective

To identify risk factors for NCM in patients with LCMN and suggest guidelines for their management.

Methods

Medical records of patients with LCMN were reviewed at Sainte-Justine Hospital between 1980 and 2006. Presence of multiple satellite nevi and posterior midline location were evaluated as risk factors for NCM using chi-square test. Magnetic resonance imaging scans were reviewed by a neuroradiologist.

Results

Twenty-six of 52 patients underwent radiologic investigation. Six of 26 (23%) had NCM. Patients with this condition are more likely to have multiple satellite nevi (100% vs 50%, P  = .03) and have a trend to posterior midline location of their LCMN (100% vs 60%, P  = .08). Patients with NCM are more likely to have both multiple satellite nevi and posterior midline location (100% vs 25%, P  = .002). Radiologic findings are also presented.

Limitations

This was a retrospective case series with imprecise chart data in 38% of cases.

Conclusion

The presence of multiple satellite nevi alone or with associated posterior midline location of LCMN is associated with a higher risk of NCM. We recommend magnetic resonance imaging testing before 4 months of age in patients with these features.

The full text of this article is available in PDF format.

Abbreviations used : CI, LCMN, MCMN, MRI, MSN, NCM, NPV, PML, PPV



 Funding source: None.
 Conflicts of interest: None declared.



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