Papillomatous Compound Nevus

An 8-year-old boy was observed for 5 years for an enlarging, pigmented lesion on his left lower lid (Fig 1). An excisional biopsy was performed and histopathology (H&E) revealed skin with keratinized, stratified squamous epithelium in a papillomatous configuration (Figs 2 and 3). The lesion had nests of densely pigmented melanocytes within the epithelium (black arrows), at the epithelial-stromal junction (white arrows) and within the underlying stroma (asterisks). The history of growth and the junctional location are of much less concern in a juvenile nevus than in an adult nevus.