Dermatosurgical Problems: Cerebriform Intradermal Melanocytic Nevus Developing from а Giant Congenital Scalp Nevus

Authors report a 8-year-old boy who presented to the dermatology department with progressive hair loss and intense itching involving the right temporal region, the right half of the scalp vertex, and the right half of the frontal region. He was born with a giant congenital scalp nevus classified as large (22cm x 28cm), without hypertrichosis or satellite lesions (a-c). After eight years, the lesion demonstrated notable changes, including loss of pigmentation, progressive enlargement alongside intense pruritus and discomfort (d). Histopathological examination confirmed the diagnosis of a cerebriform (congenital) intradermal melanocytic nevus. Differential diagnoses included nevus sebaceous, which is known also to undergo malignant transformation.Given the risk of degeneration or malignant transformation into melanoma, surgical excision with consideration of reconstructive approaches - due to the expected large primary defect - was recommended.