Clinical manifestation

Congenital variant: size ranging from <1 cm to lesions covering most of the integument; range in color from tan to deep blue-black; may begin as patch and become palpable as child ages; associated satellite pigmented papules, especially in patients with giant congenital nevus (>20 cm in diameter); melanoma risk increases with size of congenital lesion

Nevus of Ota and Ito

Acquired variant: sharply marginated, uniform tan to brown, smooth to verrucous papule or macule, usually <1 cm in diameter

Spitz (spindle cell) nevus variant: uniform, smooth, reddish-brown papule, often with fine overlying scale, usually occurring in childhood

Blue nevus variant: uniform, firm, blue papule

Clark's nevus (atypical mole, dysplastic nevus) variant: reddish-brown flat papule, with central elevation and feathered red border ("fried egg appearance"), often >0.5 cm in diameter; sometimes marker of risk for melanoma, particularly with family history of melanoma or presence of multiple lesions

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