Introduction

Melanocytic nevi with eccentric foci of hyperpigmentation (“Bolognia sign”) may simulate melanoma and have been described as a distinct type of acquired melanocytic nevus.

Case report

This report presents the case of a 2-year-old girl with a congenital melanocytic nevus on the back and describes the morphological and dermoscopic changes observed over a 24-month follow-up period.

Conclusions

Dermoscopic follow-up enables monitoring of morphological changes that may mimic melanoma in congenital melanocytic nevi. Based on the available literature and our observation, such benign evolutionary changes appear to be characteristic of nevi in children. Recognition of this pattern may help avoid unnecessary excision and its associated risks, including anesthesia and hypertrophic scarring. In adults, however, in such type of nevi surgical excision is generally recommended.