Moles and melanoma

The melanoma epidemic in adults is well documented, and there is now evidence that the incidence of malignant melanoma in teenagers is increasing. Risk factors for melanoma are recognizable in children and include congenital nevi, numerous common nevi, and atypical nevi. Large congenital nevi overlying the head or spine also carry risk for central nervous system involvement, which, if symptomatic, carries a grave prognosis. Laser therapy has recently been advocated for small congenital nevi but often yields only temporary improvement. Adjuvant therapy with interferon alfa-2b holds promise for patients with metastatic melanoma. Melanoma risk is also linked to sun sensitivity and childhood exposures, and sunscreen use has been promoted for prevention of skin cancer. Because many sunscreens offer protection from ultraviolet (UV) B but not UVA, spectra that may be involved in melanoma induction, pediatricians should counsel their families to practice a full program of sun protection that includes sun avoidance and protective clothing and eyeware in addition to sunscreens.