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Pigmented dermatoses are a frequent reason for pediatric dermatologic care, especially melanocytic nevi. Although they have a low risk of progression to melanoma, they may require excision if they affect the patient's quality of life due to their location in visible sites or specific areas such as the genitals. We present the unusual case of an adolescent with a melanocytic nevus located on the genitals, who underwent surgical management.

11-year-old male patient who presented with a melanocytic nevus affecting the penis and with no additional abnormalities on the remainder of the physical examination. Due to the impact on quality of life, the entire pigmented plaque was excised with a 5-mm margin of healthy skin, and reconstruction of the cutaneous defect and the foreskin was performed. The histopathological study reported a completely excised intradermal melanocytic neurotized nevus, with no malignant criteria.

Congenital melanocytic nevi can be treated with complete excision when they affect patients' quality of life due to their location in sensitive sites, such as the genitals. Adequate reconstruction improves the patient's prognosis, as these types of lesions often cause anxiety and depression, especially in adolescents.