National Journal of Laboratory Medicine. 2016 Jul, Vol-5(3): PO38-PO43 38 Original Article DOI: 10.7860/NJLM/2016/19081.2140 ABSTRACT Introduction: Melanocytic lesions in children are unique challenging propositions both for the dermatologist and the pathologist. The potential for malignant change in melanocytic lesions is a cause for concern and distinction between benign nevus and malignant melanoma is crucial and at times can be extremely difficult. Aim: To decipher the clinicopathological spectrum of melanocytic lesions in Asian children because of rarity of such studies in our population. Materials and Methods: A retrospective analysis of all the cases diagnosed as melanocytic lesions in children less than 14 years of age was carried out between 1995 and 2014. The demographic data including the age at diagnosis, gender and site of lesion was compiled from the case files. Histopathological findings and final diagnosis rendered were also studied. Results: Skin and conjunctival biopsy specimens of melanocytic lesions from 27 pediatric patients formed the study group. The age at presentation ranged from 8 months to 14 years. The mean age at diagnosis was 10.28 years. Twelve (44.44%) lesions were from male children and 15 (55.56%) from female children. Majority, 18 (66.67%) were found in head and neck region. Of 27 childhood melanocytic lesions, 5 (18.52%) were benign pigmented lesions, 20 (74.07%) were benign nevi and 1 (3.70%) case each of non-giant congenital melanocytic nevus and Spitz nevus. No case of malignant melanoma was reported. Conclusion: Our data highlights the female predominance of pediatric melanocytic lesions, with benign nevi being the most common and head and neck a favored site. Pediatric melanoma although a rarity in Asian children, should not be missed and must be differentiated from atypical spitzoid lesions, the great mimickers of true melanoma. INTRODUCTION Melanocytic lesions in children are unique challenging propositions both for the dermatologist and the pathologist. Melanocytic lesions are common in the pediatric age group and a vast majority of these lesions are benign [1]. They arise from proliferation of one or more of these cells: melanocytes, nevus cells or melanoma cells. Childhood melanocytic lesions comprise a broad spectrum of benign and rarely malignant conditions. They are usually divided into benign pigmented lesions, also known as melanocytoses (freckles, solar lentigines, lentiginosis, Becker’s melanosis, Mongolian spot, blue nevus), benign nevi (junctional, compound, intradermal), special variants of nevi (Spitz nevus, spindle cell nevus, non- giant and giant congenital melanocytic nevus, dysplastic nevus) and malignant melanoma [2]. Systemic anomalies like spinal dysraphism and neuro- cutaneous melanosis can also coexist with melanocytic lesions in children [3]. The potential for malignant change in melanocytic lesions is a cause for concern and distinction between benign nevus and malignant melanoma is crucial and at times can be extremely difficult. For instance, the histological features in spitz nevi can closely mimic those of malignant melanoma. It is therefore important for pathologists and clinicians to be aware of the spectrum of melanocytic lesions in children as well as potentially worrisome features of pigmented lesions. Although the incidence of melanoma has increased dramatically over the past three decades, childhood melanoma still remains uncommon [4-6]. A literature search shows the paucity of studies on childhood melanocytic lesions in the Asian region. The aim of the present study was to decipher the clinicopathological spectrum of melanocytic lesions in Asian children because of rarity of such studies in our population. MATERIALS AND METHODS Patients A retrospective analysis of all the cases diagnosed as melanocytic lesions in children (under 14 years of age) between January 1995 and December 2014 from Department of Pathology, Tertiary Care Hospital, North India was undertaken. Patients less than 14 years of age were included based on the availability of the clinicopathological data. The histopathological Pathology Section Keywords: Congenital nevus, Melanoma, Pigmented lesions, Spitz nevus. RAJPAL SINGH PUNIA, REETU KUNDU, MEENAKSHI GARG BANSAL, GEETA GARG, HARSH MOHAN Clinical and Microscopic Evaluation of Pediatric Melanocytic Lesions