Which statement correctly describes distinguishing features of congenital nevi and café-au-lait macules?

• A. It is usually flat
• B. Café-au-lait macules darken over time
• C. Congenital nevi are never raised
• D. Congenital nevi can be mistaken for café-au-lait macules but will darken over time and have a well-defined edge

Answer: (D)

When distinguishing congenital nevi from café-au-lait macules, focus on how they evolve and how their borders appear. Café-au-lait macules are flat patches with uniform color and smooth, well-defined borders, and they typically stay the same in size and color over time. Congenital nevi, present at birth, often have a clearly defined edge and can darken as the child grows; they may also become raised or nodular. Because congenital nevi can resemble café-au-lait macules initially, recognizing that they tend to darken over time and possess a well-defined edge helps separate them from café-au-lait macules.