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Congenital melanocytic nevus (CMN) is a benign proliferative skin disease in the epidermis and dermis. Large to giant CMNs are estimated to be associated with an increased lifetime risk of malignancy. It is necessary to estimate and monitor the risk of malignant transformation for giant CMNs. To date, the clinical "ABCD" criteria and immunohistochemistry studies can be confusing and, to some extent, subjective. Accordingly, the elucidation of genomic analyses of nevi is required to better understand the malignant transformation of CMNs. Here, we describe two large to giant CMNs of the scalp with opposite clinical-histological and molecular evaluations of potential malignancy risk. To our knowledge, this is the first description of a genetic study of large to giant CMNs of the scalp in East Asia. We recommend reviewing the molecular diagnosis together with careful medical history and histological information to facilitate the evaluation of the potential malignancy risk. [ABSTRACT FROM AUTHOR]

The article presents the case study of a 45 year old female patient who was born with erythema lesions in the right nuchal and occipital area. The lesions were flat and non-hypertrophic. Recently several nodules began forming above the erythema. The biopsy is performed in the nodules and flat erythema lesion site in the nuchal area and the tissues were sent for pathologic and genetic study.