Birthmarks - pigmented

Definition

A birthmark is a skin marking that is present at birth. Birthmarks include cafe-au-lait spots, moles, and mongolian spots. Birthmarks can also be red.

Alternative Names

Nevus sebaceous; Hairy nevus; Nevi; Mole; Cafe-au-lait spots; Congenital nevus

Causes

Cafe-au-lait spots may occur in people with the genetic disorder, neurofibromatosis.

Nearly everyone has moles, which usually appear after birth.

Mongolian spots are more common in people with darker skin. 

Symptoms

Each type of birthmark has its own appearance:

• Cafe-au-lait spots are light tan, the color of coffee with milk.
• Moles are small clusters of colored skin cells.
• Mongolian spots (also called Mongolian blue spots) are usually bluish or bruised-looking. They usually appear over the lower back or buttocks. They are also found in other areas such as the trunk or arms.

Other symptoms of birthmarks:

• Abnormally dark or light skin
• Growth of hair from pigmented skin
• Skin lesion
• Skin lumps
• Textured skin that can be smooth, flat, raised, or wrinkled

Exams and Tests

The doctor will examine your skin to make the diagnosis. You may have a biopsy to look for skin changes that are signs of cancer. The doctor may take pictures of the birthmark to compare changes over time.

Treatment

The type of treatment you have depends on the type of birthmark and related conditions. Usually no treatment is needed for the birthmark itself.

Large birthmarks that affect your appearance and self-esteem may be covered with special cosmetics.

You may have surgery to remove moles if they they affect your appearance or have an increased cancer risk. Talk to your doctor how and when to remove any moles.

Support Groups

Nevus Outreach is a support group for people with large birthmarks called nevi.

Outlook (Prognosis)

Large moles that are present at birth (congenital nevi) are more likely to become skin cancer (malignant melanoma). This is especially true if the mole covers an area larger than the size of a fist. The cancer risk is related to the size, location, shape, and color of the mole.

Mongolian spots may persist for months or years. They do NOT become cancer or develop other symptoms.

Possible Complications

• Skin cancer
• Emotional distress if the birthmark affects appearance

When to Contact a Medical Professional

Have a health care provider examine any birthmark. Report changes in the birthmark to your health care provider, including:

• Bleeding
• Color change
• Inflammation
• Itching
• Open sore (ulceration)
• Pain
• Size change
• Texture change

Prevention

There is no known way to prevent birthmarks. A person with birthmarks should use a strong sunscreen when outdoors (to prevent complications).

References

Habif TP. Premalignant and malignant nonmelanoma skin tumors. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 21.

Morelli JG. Diseases of the neonate. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook
of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 639.

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