Lisa M. Flegel,1 Joseph M. Lam, MD, FRCSC,2

1Medical Degree Undergraduate Program, Northern Medical Program, University of British Columbia, BC.
2Clinical Assistant Professor, Department of Pediatrics and Dermatology, University of British Columbia, BC.


Abstract: Hyperpigmented lesions are common in the pediatric population and identifying their etiologies can be challenging for physicians. Patients and caregivers may worry that hyperpigmented lesions are dangerous, associated with an internal illness or that they may lead to skin cancers. Having a better understanding of the causes and natural histories of these lesions may help to guide management and alleviate worry. This review article will provide an overview of select common and uncommon causes of hyperpigmented skin lesions in children.
Key Words: hyperpigmentation, pediatric.
1. Most hyperpigmented lesions in children do not require treatment aside from for cosmesis.
2. Features of malignant melanoma in children include: non-pigmented, uniform color, variable diameter, nodular lesions, and occurring de novo.
3. Parents and children should be warned that melanocytic nevi will grow as their child grows, but growth should be proportionate.
4. The risk of melanocytic nevi becoming malignant melanoma in children is very small.
In children with numerous melanocytic nevi, a good rule of thumb is to look for the 'ugly duckling' mole.
To track lesions over time, parents can develop a routine of taking a picture each year on the child's birthday.
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