Common moles on the skin, known scientifically as melanocytic nevi, are seen frequently in the pediatric population. They are broadly grouped into two groups: congenital (generally present at birth or in infancy) or acquired. Congenital melanocytic nevi (CMN) are classified based on size and morphologic features. Neurocutaneous melanosis and melanoma represent two important complications, with overall risk affected by nevus size, location, appearance, and number of satellite lesions. Regular lifelong skin surveillance is required for high-risk CMN. Acquired melanocytic nevi (AMN) tend to appear in childhood and increase in number through adolescence. Risk factors for melanoma in children with moles include having more than 50 AMN, clinically atypical AMN, family history of melanoma, excessive ultraviolet light exposure, lightly pigmented skin, and immunosuppression. Children with risk factors should be monitored regularly. The periodic health examination presents an opportunity to perform total body skin examination to screen for concerning lesions and to provide anticipatory guidance about sun protection. [Pediatr Ann. 2016;45(8):e293-e298.].
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