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This is a variant of congenital nevus which may be confused with malignancy

For people with fair skin, including many with red hair, tanning naturally can be difficult and often leads to sunburn

C-kit is a transmembrane growth factor expressed in basal skin cells, melanocytes, epithelial cells of the breast, and mast cells, stimulation of which leads to activation (followed by the rapid degradation) of microphthalmia transcription factor (MITF)

discussion 168

Although these are innocuous lesions, a biopsy is usually warranted for diagnosis since mucosal melanoma can mimic the appearance of a melanotic macule

A separate study reported the utility of assessing for the status of a member of the Ras association domain family (RASSF), specifically RASSF10