birthmark

A birthmark is a congenital, benign irregularity on the

skin

which is present at

birth

or appears shortly after birth—usually in the first month. They can occur anywhere on the skin. Birthmarks are caused by overgrowth of blood vessels, melanocytes,

smooth muscle

,

fat

,

fibroblast

s, or keratinocytes.

Dermatologists divide birthmarks into two types: pigmented birthmarks and vascular birthmarks. Pigmented birthmarks caused by excess skin pigment cells include: moles, café au lait spots, and Mongolian spots. Vascular birthmarks, also called red birthmarks, are caused by increased blood vessels and include macular stains (salmon patches), hemangiomas, and Port-wine stains. A little over 1 in 10 babies have a vascular birthmark present by age 1. Several birthmark types are part of the group of skin lesions known as

nevi

or naevi, which is

Latin

for "birthmarks".

Birthmarks occur as a result of a localized imbalance in factors controlling the development and

migration

of skin cells. In addition, it is known that vascular birthmarks are not hereditary.

Pigmented types

Mole

Congenital melanocytic nevus is a type of melanocytic nevus, the medical term for what is colloquially called a "mole", found in

infant

s at birth. Occurring in about 1% of infants in the

United States

, it is located in the area of the

head

and

neck

15% of the time, but may occur anywhere on the body. It may appear as light brown in fair-skinned people, to almost black in people with darker skin. Coming in a variety of sizes and appearances, they may be irregular in shape and flat, or raised and lumpy in appearance and feel. Such naevi can also manifest themselves as beauty marks, which most commonly appear on the

face

,

neck

or

arm

s.

Café au lait spot

Café au lait spot

macule

s may occur anywhere on the body. They are most commonly oval in shape and light brown, or milk coffee, in color. These birthmarks may be present at birth, or appear in early childhood, and do not fade much with age. One or two on an individual is common; however, four or more may be an indicator of

neurofibromatosis

. In the event of weight gain, the birthmark can stretch with the skin and become larger.

Mongolian spot

A Mongolian blue spot (dermal melanocytosis) is a benign flat congenital birthmark with wavy borders and irregular shape, most common among

East Asia

ns and Turkic people (excluding Turks of

Asia Minor

), and named after

Mongolians

. It is also extremely prevalent among East Africans and Native Americans.About Mongolian Spot
/ref>Mongolian blue spots
- Health care guide discussing the Mongolian blue spot. It normally disappears three to five years after birth and almost always by

puberty

. The most common color is blue, although they can be blue-gray, blue-black or even deep brown.

The Mongolian spot is a congenital developmental condition exclusively involving the

skin

. The blue colour is caused by melanocytes,

melanin

-containing cells, that are deep under the skin. Usually, as multiple spots or one large patch, it covers one or more of the lumbosacral area (lower

back

), the buttocks, sides, and

shoulder

s. It results from the entrapment of melanocytes in the dermis during their migration from the

neural crest

to the epidermis during

embryo

nic development.

Among those who are not aware of the background of the Mongolian spots, it may sometimes be mistaken for a bruise indicative of child abuse.Mongolian Spot
- English information of Mongolian spot, written by Hironao NUMABE, M.D., Tokyo Medical University.

Vascular types

Stork bite

Colloquially called a "

stork

bite", "

angel

's kiss" or "

salmon

patch", telangiectatic nevus appears as a pink or tanned, flat, irregularly shaped mark on the

knee

, back of the neck, and/or the

forehead

,

eyelid

s and, sometimes, the top

lip

. The skin is not thickened and feels no different from anywhere else on the body; the only difference is in appearance. Nearly half of all babies have such a birthmark.

Strawberry mark

An

infantile hemangioma

, colloquially called a

strawberry

mark, is a benign self- involuting

tumor

(swelling or growth) of endothelial cells, the cells that line blood vessels. It usually appears during the first weeks of life and resolves by age 10. It is the most common

tumor

of

infancy

.

PHACES Syndrome, a rare condition that often involves

brain

,

heart

, and

arterial

abnormalities, is generally accompanied by the presence of large facial hemangiomas. In such cases, what appears to be a small

bruise

or birthmark may grow rapidly and take on a puffy appearance in the first days or weeks of life.

Port-wine stain

Port-wine

stains, also known as nevus flammeus and sometimes mistaken for strawberry marks, are present at birth and range from a pale pink in color, to a deep wine-red. Irregular in appearance, they are usually quite large, and caused by a deficiency or absence in the

nerve

supply to blood vessels. This causes

vasodilation

, the dilation of blood vessels, causing blood to pool or collect in the affected area. Over time, port-wine stains may become thick or develop small ridges or bumps, and do not fade with age. Such birthmarks may have emotional or social repercussions. Port-wine stains occur in 0.3% of the population, equally among males and females. They frequently express unilaterally, i.e., on only one side, not crossing the midline of the body. Often on the face, marks on the upper eyelid or forehead may be indicative of a condition called Sturge-Weber syndrome. Additionally, port-wine stains in these locations may be associated with

glaucoma

and seizures.

Treatment

Most birthmarks are harmless and do not require treatment. Pigmented marks can resolve on their own over time in some cases. Vascular birthmarks may require reduction or removal for cosmetic reasons. Treatments include administering oral or injected

steroid

s, dermatological lasers to reduce size and/or color, or dermatologic surgery.

References

External links

Birthmarks
via the

Cleveland Clinic

Vascular Birthmarks Foundation
via MedlinePlus

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Skin