Nevi

Case history

A 39-year-old woman with no personal history of skin cancer presents for a skin examination after her sister was recently diagnosed with melanoma. She states that she is concerned that she may have skin cancer because she has a history of several blistering sunburns as a child, and that she has lots of moles. One lesion on her back, in particular, appears to have become darker and more raised, and she would like it checked. On full body skin exam, she has freckling of sun-exposed surfaces of her face, chest, upper back, and arms, in addition to numerous dark-brown to pink, 3- to 5-mm, evenly bordered macules and papules scattered on her face, back, and arms. The nevus in question on her back is an evenly pigmented, dark brown, dome-shaped 5-mm papule with a mammillated surface and circumscribed border.