Melanoma and melanocytic nevi in paediatric patients: a single institution experience.

BACKGROUND: Melanoma is an infrequent neoplasm in children and adolescents. The number of consultancies for melanocytic nevi control in the paediatric population is increased by the major anxiety of parents and paediatricians.

METHODS: A retrospective chart review was performed in order to evaluate the incidence rate of melanoma, Spitz nevi, congenital and acquired melanocytic nevi in patients aged 14 years or less and referred to our institution from April 2010 to September 2015.

RESULTS: A total of 32755 dermatologic paediatric consultancies were performed in the considered 66 months period, including 4260 patients referred for mole control (13%). During the same period, a total of 5193 excisions of melanocytic lesions were performed (adults and paediatric patients), 259 of which were performed in 250 patients aged 14 years or less (4.98%). Only 1 in situ melanoma of the nail matrix was detected in a 12-year-old female patient (0.38% of surgical excisions). The number needed to excise (NNE) in our paediatric population, calculated by comparing the total number of excised lesions and the number of melanomas found, was 259.

CONCLUSIONS: Our data lead to 3 major observations: 1) the rarity of melanoma in patients with 14 years of age or less is confirmed; 2) the number of excisions performed in this paediatric population is extremely high; 3) neither the cases of melanoma and atypical Spitz neoplasm (ASN) nor the majority of Spitz nevi were referred to us for a generic mole control. Mole controls in the paediatric population should be properly addressed, incrementing the attention on specific suspicious cutaneous lesions.