Differential Diagnosis for a 6-year-old Boy with a Changing Mole on the Chest

Single Most Likely Diagnosis

• Benign Nevi (Moles) with Normal Variation: Many moles in children change in color and size as the child grows, which can be a normal variation and not necessarily indicative of a serious condition.

Other Likely Diagnoses

• Atypical Nevi: These are moles that are unusual in appearance and can be a precursor to melanoma, but they are more common and not necessarily cancerous.
• Congenital Melanocytic Nevus: A type of mole present at birth that can change over time, potentially increasing the risk of melanoma.
• Seborrheic Keratosis: A benign skin growth that can appear as a mole and change in appearance over time.

Do Not Miss Diagnoses

• Melanoma: Although rare in children, melanoma is a deadly skin cancer that can present as a changing mole. Early detection is crucial for treatment and survival.
• Spitz Nevus: A rare type of mole that can mimic melanoma and requires careful evaluation to distinguish between the two.

Rare Diagnoses

• Blue Nevus: A rare type of mole that can appear blue due to the depth of the pigment in the skin, which can change in size and color.
• Malignant Melanoma in a Giant Congenital Nevus: A rare but serious condition where a large mole present at birth develops into melanoma.
• Leopard Syndrome: A rare genetic disorder characterized by multiple moles and other systemic features, which can include changes in the appearance of moles over time.

Each of these diagnoses requires careful consideration of the mole's characteristics, the child's medical history, and potentially, a dermatological examination and biopsy for definitive diagnosis.