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Birthmarks

Birthmarks occur where there is an over-abundance of a particular component of normal skinsuch as tiny blood vessels (capillaries) or pigment cells.The cause of this local condition is unknown.

The flat, pink birthmarks commonly seen on theforehead, eyelids, back of the neck, and above the bridgeof the nose are called capillary hemangiomas, alsoknown as "stork bites" or "salmon patches." These areseen in about 50 percent of newborns. Eyelid patcheswill disappear by three to six months of age, while thoseon the neck will fade but may last for years.

Areas of dark or bluish gray pigmentation knownas Mongolian spots are com-mon on the low back and buttocks of dark-skinnednewborns, although these marks may be found in allracial and ethnic groups. These marks vary greatly insize and shape and usually disappear by two to threeyears of age.

A more permanent type of birthmark is the café anbait spot, a light brown flat patch that can occur any-where on the body. While some are present at birth, oth-ers may appear later in life. While these markings arebenign, the presence of six or more of them measuringmore than 15 mm (about 5/8 inch) in diameter may in-dicate a more serious problem known as neurofibro-matosis (see neurofibromatosis).

One or more dark brown, black, or blue-black spotsknown as nevi, which contain large numbers of pig-mented cells, may be seen at birth in about one in onehundred Caucasian infants. While the vast majority ofthese spots never cause any trouble, on rare occasion(usually in adolescence or even later in adulthood), oneor more may transform into a dangerous type of skincancer called a malignant melanoma. You should be-come familiar with the appearance of arty nevi on yourchild's skin and watch in particular for any of the fol-lowing warning signs: significant change in size; crust-ing, oozing, or bleeding; the development of an irregularborder or color pattern; and change from a flat to araised or rough contour. Should any of these changes de-velop, ask your child's doctor or a dermatologist to ex-amine the area.

A more troublesome (but also uncommon) b.mark is the giant pigmented nevus, an irregular r,dark brown patch over four inches in diameter. IIthis covers a large area of the lower trunk, it is call"bathing trunk nevus." At a microscopic level thstructurally similar to the common moles (or juncfinevi), which become more common and widespover the skin later in life. Unfortunately, giant pigmenevi are much more likely than the smaller congepigmented nevi to transform into malignmelanomas. This change can occur during infancyany time later in life. For this reason a consultationa dermatologist or plastic surgeon may be recommeiat an early age.

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