Photo Rounds

Brown spot on right foot

A 6-month-old boy was brought to his family physician (FP) because his parents noted a new brown spot on his right foot. They didn’t remember seeing this spot at birth, and were worried that it could be a skin cancer. The child was otherwise healthy.

What’s your diagnosis?


The FP recognized this as a benign congenital nevus .

While most congenital nevi are visible at birth, there are some that appear in the first year of life and are known as tardive congenital nevi. The FP used a dermatoscope to look at this nevus and found that its features were benign.

The parents wondered whether this needed to be removed to prevent it from becoming skin cancer in the future. The FP reassured them that the risk of melanoma from this one nevus was too small to warrant a prophylactic surgical excision. The parents agreed to the standard 6-month immunizations.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Smith, M. Congenital nevi. In: Usatine R, Smith M, Mayeaux EJ, et al. Color Atlas of Family Medicine . 2nd ed. New York, NY: McGraw-Hill; 2013:953-957.

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