Junctional nevi

Published on 11/06/2015 by admin

Filed under Pediatrics

Last modified 22/04/2025

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Acquired 4-mm junctional nevus on infant’s back.

Junctional and compound nevi on teen’s back.

CLINICAL FEATURES

Junctional nevi are acquired, flat, brown macules. They may appear in the first few months of life and increase in number during the preteen growth spurt and through teen years. Thirty-five percent of 1-year-olds have one junctional nevus; teens have several dozen. Junctional nevi predominantly are seen on the lateral upper arms, trunk and face.

On the extremities, they tend to remain flat, on the face and back, some are raised over time to become compound nevi. A junctional nevus has groups of extra melanocytes at the junction of the epidermis and dermis. With age, more melanocytes appear deeper in the dermis and some nevi will eventually lose their junctional groups of melanocytes with only dermal melanocytes remaining.

On the palms and soles, junctional nevi often appear to have irregular borders because of the swirly pattern of dermal ridges and may be clinically misdiagnosed as melanomas.

On the scalp, they appear with a rim of brown pigment and a lighter center. Sudden change in size or shape of a junctional nevus is usually the result of irritation.

TREATMENT

No treatment is necessary. Surgical removal for cosmetic reasons will result in a scar. Destruction techniques should be avoided because there is no pathology available for study.