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Congenital naevi are usually found in
newborn infants. These are usually solitary lesions and are mostly
located on the trunk. These are also found on the lower extremities and
scalp. Most of these naevi are usually less than 10 mm in diameter.
Giant congenital naevi are more than 20 mm in diameter.
Histopathology reveals that the lesion may be junctional, compound or
intradermal in type.
Naevus cells are present in the lower two-third of the dermis. These
cells extend around the nerves, blood vessels and adnexae. Involvement
of eccrine glands and septa is an important feature of a true congenital
naevus. Naevus cells extend between collagen fibres singly or in a
Indian file pattern.
Melanoma arising in small congenital naevi has a less aggressive growth
pattern. Melanoma arising in giant congenital naevi are usually non
epidermal in origin. The tumour cell patterns include spindle and round
cell differentiation, malignant blue naevus and heterologous
differentiation (eg neurosarcoma, liposarcoma, rhabdomyosarcoma etc)
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