Spontaneous involution of congenital melanocytic nevi of the scalp

Large or giant congenital melanocytic nevi are rare. They are associated with a risk of melanoma, which is poorly quantified, and often represent a major cosmetic problem. Surgical intervention is the most common treatment, although dermabrasion or curettage in the first weeks of life is used in some centers. When these nevi occur in the scalp, the risk of melanoma has been reported to be lower. Here we describe a series of children in whom large congenital melanocytic nevi on the scalp appeared to spontaneously involute. Therefore, our findings indicate that these nevi also have a better prognosis cosmetically. It is suggested that the decision about surgical treatment should be deferred until the maximal improvement in appearance has occurred during the first 2 years of life.