Giant pigmented nevi are congenital melanocytic nevi that are of great cosmetic distress for the patient and cause an equal psychological stress to the parents. Here we report a case of a 4 year old female child who presented to us with a large black patch over her back extending upto upper half of her buttocks with multiple satellite lesions all over the body, since her birth. Their management is a challenge for the treating dermatologist owing to their large size and a propensity to recur. There have been reports of malignant change in upto 2% to 15% of the cases. However, there have been recent advances in the field with many new therapeutic modalities available.
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