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Birthmarks - pigmented

Definition

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

See also: Birthmarks - red

Alternative Names

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

Causes, incidence, and risk factors

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 commonly seen in darker-skinned populations.

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, but can also appear in other areas, including the trunk or arms.

Other symptoms of birthmarks:

• Abnormally dark or light skin
• Contain hair
• Skin lesion
• Skin lumps
• Textured -- smooth, flat, raised, or wrinkled

Signs and tests

Diagnosis is usually made based on the appearance of the skin area. A biopsy may be performed to look for cancerous changes.

Treatment

Treatment varies depending 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.

Moles may be removed surgically if they affect your appearance or have an increased cancer risk. Discuss your options with your doctor to decide how and when to remove any moles.

Support Groups

Nevus Outreach -- www.nevus.org

Expectations (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.

Complications

• Skin cancer
• Psychological effects, if the birthmark is prominent

Calling your health care provider

Have any birthmarks examined by a health care provider. Report any 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 good quality 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. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 646.