This report describes a newborn with a congenital melanocytic nevus (CMN) over the scalp, which gave a striking appearance of an Ascot cap. Though CMN are common, their location gives a unique look and associated findings (dermatological lesions like satellite lesions, café-au-lait spots, Mongolian spots, etc.) are often underappreciated in clinical practice. Through this report, we also wish to convey a message that clinicians should decide the need for investigations (MRI brain to rule out neurocutaneous melanosis) in these benign conditions are based on individual risks rather than merely the presence of CMN.
van Engen-van GrunsvenAC, Kusters-VandeveldeH, GroenenPJ, BlokxWA.Update on molecular pathology of cutaneous melanocytic lesions: What is new in diagnosis and molecular testing for treatment?Front Med (Lausanne). 2014;1:39. doi:10.3389/fmed.2014.00039.
2.
KrengelS, ScopeA, DuszaSW, VontheinR, MarghoobAA.New recommendations for the categorization of cutaneous features of congenital melanocytic nevi. J Am Acad Dermatol. 2013; 68(3): 441–451. doi:10.1016/j.jaad.2012.05.043.
3.
CastillaEE, da Graça DutraM, Orioli-ParreirasIM. Epidemiology of congenital pigmented naevi: I. Incidence rates and relative frequencies. Br J Dermatol. 1981;104(3):307–315. doi:94 10.1111/j.1365-2133.1981.tb00954.x.
4.
Martins da SilvaVP, MarghoobA, PigemR, CarreraC, AguileraP, Puig-ButilléJA. . Patterns of distribution of giant congenital melanocytic nevi (GCMN): The 6B rule. J Am Acad Dermatol. 2017;76(4):689–694. doi: 10.1016/j.jaad.2016.05.042.
5.
RwalahMM.Large congenital melanocytic nevus associated with the Dandy-Walker complex: A case report. RMJ. 2011; 36(4): 326–328.
6.
IbrahimA, RamatuA.Congenital giant melanocytic nevus with ambiguous genitalia in an 8-year-old child: A rare combination. Saudi J Health Sci. 2013; 2: 214–216.
7.
VianaAC, GontijoB, BittencourtFV.Giant congenital melanocytic nevus [published correction appears in An Bras Dermatol. 2014 Jan-Feb;89(1):190]. An Bras Dermatol. 2013; 88(6): 863–878. doi:10.1590/abd1806-4841.20132233.
8.
AlikhanA, IbrahimiOA, EisenDB.Congenital melanocytic nevi: where are we now? Part I. Clinical presentation, epidemiology, pathogenesis, histology, malignant transformation, and neurocutaneous melanosis. J Am Acad Dermatol. 2012;67(4):495.e1–17; quiz 512-4. doi:10.1016/j.jaad.2012.06.023.
SlutskyJB, BarrJM, FemiaAN, MarghoobAA.Large congenital melanocytic nevi: associated risks and management considerations. Semin Cutan Med Surg. 2010; 29(2): 79–84. doi:10.1016/j.sder.2010.04.007.
11.
KadonagaJN, FriedenIJ.Neurocutaneous melanosis: definition and review of the literature. J Am Acad Dermatol. 1991;24(5 Pt 1):747–755. doi:10.1016/0190-9622(91)70115-i.
12.
JahnkeMN, O’HaverJ, GuptaD. . Care of congenital melanocytic nevi in newborns and infants: Review and management recommendations. Pediatrics. 2021;148(6):e2021051536. doi:10.1542/peds.2021-051536.
13.
RuggieriM, PolizziA, CatanzaroS, BiancoML, PraticòAD, Di RoccoC.Neurocutaneous melanocytosis (melanosis). Childs Nerv Syst. 2020; 36(10): 2571–2596. doi:10.1007/s00381-020-04770-9.
14.
WaelchliR, AylettSE, AthertonD, ThompsonDJ, ChongWK, KinslerVA.Classification of neurological abnormalities in children with congenital melanocytic naevus syndrome identifies magnetic resonance imaging as the best predictor of clinical outcome. Br J Dermatol. 2015; 173(3): 739–750. doi:10.1111/bjd.13898.
