Related concepts:

Angel kiss, Stork bites, Nevus simplex, Telangiectatic nevus, Unna’s nevus

Introduction to salmon patches:

Angel kisses and stork bites are among the picturesque names given to these very common birthmarks. Parents often worry that these will last a lifetime or get darker with time – the opposite tends to be true. They are tiny windows into the past.

What are salmon patches?

Salmon patches (nevi simplex) are dilated capillaries in the skin. They are not new capillaries or new growths, but leftover patches of the way the blood vessels looked during fetal circulation.
These are different birthmarks than hemangiomas or port wine stains; salmon patches are also more common.

Who gets salmon patches?

Before birth, every child has salmon patches. By the time a baby is born, only about one third do.

What are the symptoms of salmon patches?

Salmon patches appear as flat, dull pink patches. Most commonly they occur at the nape of the neck (stork bites), between the eyebrows or over the eyelids (angel kisses), or around the nose or mouth.
Because they are collections of blood vessels in the skin, they tend to look darker or redder when a baby is crying, excited, or upset. This may even be true after the patch has seemed to have disappeared.

Are salmon patches contagious?

No

How long does salmon patches last?

Salmon patches are present at birth (and before). The great majority disappear, usually within the first year. Those around the hairline at the back of the neck (called “Unna’s nevus”) are the most likely to remain.

How are salmon patches diagnosed?

Salmon patches are diagnosed by their appearance and location.

How is salmon patches treated?

No treatment is generally necessary. The overwhelming majority disappear with no treatment. Of those that do not, most are in a location that is covered by hair.

How can salmon patches be prevented?

No prevention is necessary.

Related A-to-Z Information:

Baby Acne, Cradle Cap, Diaper Rash, Erythema Toxicum (Baby rash), Hemangioma, Inconspicuous Penis, Labial Adhesions, Lanugo, Milia, Miliaria, Moles (Nevi), Mongolian Spots, Port Wine Stain, Pustular Melanosis

Related concepts:

Mongolian Spots

Introduction to slate grey patches:

Several years ago, I met a little girl who had been taken from her parents because authorities noticed that her body, especially her buttocks, was covered with large, deep bruises. She and her parents were ripped from one another for her own good. I can only imagine what they each felt. Child abuse charges were eventually dropped when these “bruises” were correctly diagnosed as slate grey patches.

What are slate grey patches?

Slate grey patches  (also known as “Mongolian Spots”) are nothing more than dense collections of melanocytes, the skin cells which contain melanin, the normal pigment of the skin. When the melanocytes are close to the surface, they look deep brown. The deeper they are in the skin, the more bluish they look. Either way, they are not related to bruises or any other medical condition. They do not predispose to skin cancer or any other problem.

Who gets slate grey patches?

At least one Mongolian spot is present on the great majority of babies of Native American, African, Asian, or Hispanic descent. They are also present in about one in ten fair-skinned infants.
Despite the name, Slate grey patches have no known anthropologic significance, except for being more common in darker-skinned infants.

What are the symptoms of Slate grey patches?

These flat birthmarks can be deep brown, slate gray, or blue-black in color. They do sometimes look like bruises. The edges are often, but not always, indistinct. They are most common on the lower back and buttocks, but are often found on the legs, back, sides, and shoulders. They vary from the size of a pinhead to six inches or more across. A child may have one or several.

Are Slate grey patches contagious?

No

How long does Slate grey patches last?

Slate grey patches are present at birth, and most of them fade (at least somewhat) by age two. Most have completely disappeared by age five. If Slate grey patches remain at puberty, they are likely to be permanent. Fewer than five percent of children with Slate grey patches still have any by the time they reach adulthood. Those who do tend to be the ones with multiple, widespread spots, or with spots in unusual locations.

How are Slate grey patches diagnosed?

Mongolian spots are usually diagnosed by their appearance.

How are Slate grey patches treated?

No treatment is necessary.

How can Slate grey patches be prevented?

No prevention is necessary.

Related A-to-Z Information:

Baby Acne, Cradle Cap, Diaper Rash, Erythema Toxicum (Baby rash), Hemangioma, Inconspicuous Penis, Labial Adhesions, Lanugo, Milia, Miliaria, Moles (Nevi), Port Wine Stain, Salmon Patches (Stork bites)

Related concepts:

Acquired moles, Congenital moles, Giant moles, Pigmented nevi, Giant hairy nevus, Bathing-trunk nevus, Coat-sleeve nevus, Stocking nevus, Cape-like nevus.

Introduction to moles:

Parents need to know that most moles are benign, but that at least half of malignant melanomas do appear in moles. With some types of moles, this transformation into cancer often occurs during childhood.

What are moles?

When all the cells in a person do not have the same genetic make up, that person is said to be a “mosaic”. At some point in development, one cell mutates. All of its progeny will have the same DNA code — but that code will be different from the rest of the body. The timing in development when this mutation occurs will determine what proportions of the body have the two different types of DNA. All of us are mosaics to some degree. Mosaicism is the basis for most (if not all) birthmarks. It is the basis for moles and freckles. It is also the basis for tumors.
Moles or pigmented nevi are collections of pigmented cells in the skin. There are many specific types, but they are often divided into congenital (present at birth) and acquired nevi.

Who gets moles?

Congenital nevi are common birthmarks, found in about one percent of newborns. Those smaller than ¾ inch in diameter are called small nevi. Those larger than 7.5 inches in diameter are called giant nevi.
Acquired nevi are far more common. The number of moles gradually increases throughout childhood and rapidly during adolescence. By the end of adolescence, the average person has 20 to 40 moles.
Moles are more common in lighter skinned individuals. Sun exposure increases the number of moles. This is especially true of occasional, intense sun exposure and sunburns.

What are the symptoms of moles?

Moles come in a variety of shapes, sizes, textures, and sizes. They may be flat, bumpy, or dome-shaped. They may be tan, brown, black, or blue. Some are surrounded by pale halos.
Giant nevi are often nicknamed with descriptive terms according to the part of the body they cover (bathing-trunk nevus, coat-sleeve nevus, stocking nevus, cape-like nevus).
People with large or numerous moles have a higher risk of developing melanoma, one of several types of skin cancer. Danger signs that melanoma may be developing in a mole include rapid growth, crusting, bleeding, ulcers, and color changes. Malignant melanoma often has irregular borders and irregular coloring (with different shades of red or blue mixed in haphazardly with black, white, and/or brown).
The ABCDE’s of melanomas is a handy way to remember the warning signs of potentially cancerous evolution of moles.
A = Asymmetry. Moles should be symmetrical and any asymmetry warrants medical attention.
B = Borders. Moles should have even and smooth borders. Uneven, scalloped, or notched borders could signal melanoma.
C = Color. Moles are usually monochromatic. Having a variety of colors or atypical colors may be a sign of melanoma.
D = Diameter. Melanomas tend to be ¼ inch or greater. Large moles or enlarging moles could indicate the development of melanoma.
E = Evolving. A change in size, shape, color, or elevation – or any new symptom such as bleeding, itching or crusting – could be a sign of melanoma.

Are moles contagious?

No

How long do moles last?

Moles last throughout childhood. They often fade and disappear in later life.

How are moles diagnosed?

The diagnosis is based on the physical exam. Suspicious moles may need to be biopsied or removed.

How are moles treated?

Most moles do not need treatment. When they do, surgery and laser therapy are possible options.
Melanoma can arise in any mole, but during childhood the greatest risk is from giant congenital nevi. Melanoma will eventually occur in about 1 in 10 giant nevi. About half the time this happens before 5 years old. Giant nevi should be managed carefully – usually by a pediatrician, a dermatologist, and a plastic surgeon.

How can moles be prevented?

A study in the June 14th, 2000 issue of the Journal of the American Medical Association (JAMA) reported that sunscreen reduces the formation of moles in Caucasian children, especially children with freckles. The study included 458 white children. Parents of half the children were instructed to apply SPF 30 sunscreen to their children whenever they were expected to be in the sun for 30 minutes or more. These children were then followed for 3 years. They developed significantly fewer moles than their peers in the group who received no sunscreen instructions. Perhaps a longer study would have shown a protective effect in other children who don’t develop moles as quickly as fair-skinned children with freckles.
That sunscreen has the power to prevent them is good news. Applying sunscreen is a gift to children, but don’t let it lull you into a false sense of security.

Related A-to-Z Information:

Baby Acne, Cradle Cap, Diaper Rash, Hemangioma, Inconspicuous Penis, Labial Adhesions, Lanugo, Milia, Miliaria, Mongolian Spots, Port Wine Stain, Pustular Melanosis, Salmon Patches (Stork bites)

Related concepts:

Cavernous hemangioma, Strawberry hemangioma

Introduction:

“I didn’t notice that little birthmark before… “It’s cute.” “It’s huge! Will it really go away?” Parents’ reactions to these colorful birthmarks vary almost as much as the hemangiomas themselves.

What is it?

Hemangiomas are tufts of extra blood vessels that commonly occur in children.
Usually, they occur on the surface of the skin (strawberry hemangiomas). Those that are deeper in the skin are sometimes called cavernous hemangiomas. Some are mixed strawberry and cavernous hemangiomas.
Most children with hemangiomas have only one. Many have a few. Rarely, children may have many, both on the skin and in the internal organs. Some have enough extra vascular tissue to cause anemia or platelet problems.
Port wine stains and salmon patches are not hemangiomas.

Who gets it?

Hemangiomas are found on at least one in fifty babies. They tend to run in families. Girls are more likely to have hemangiomas than boys. They are also more common in babies with lighter skin coloring.
Premature babies are more likely to have hemangiomas than babies born at term.

What are the symptoms?

Strawberry hemangiomas are bright red (or purple), soft, raised, squishy birthmarks with sharp borders. They often start as little red dots surrounded by a pale halo before they grow. They are most common on the head, chest, or upper back.
Deeper cavernous hemangiomas often appear bluish, and the borders look less distinct. If the hemangioma is deep enough, the overlying skin might look normal. Most are found on the head or neck.
Most hemangiomas grow rapidly, doubling their size, and then plateau for a while before collapsing and disappearing. When the color becomes dull, or the center appears gray or pinkish-gray, the hemangioma may be entering the slow disappearing phase.

Is it contagious?

No

How long does it last?

Strawberry hemangiomas are usually not present at birth. Most appear between 3 and 5 weeks, and then grow quickly during the first six months. By the first birthday, most have already peaked in size. Many are gone by age two or three. Most are gone by school age. The great majority are gone without a trace before puberty.
Cavernous hemangiomas are more likely to be present at birth. They do not grow or disappear as rapidly. Still, more than ninety percent are gone by puberty.
In general, the size of the hemangioma and the location on the body does not correlate well with how completely it will disappear, although lip hemangiomas seem to be less likely to disappear completely.

How is it diagnosed?

Hemangiomas are usually diagnosed based on the physical exam. Sometimes blood tests or imaging studies are needed to assess the situation.

How is it treated?

The great majority of hemangiomas will disappear on their own (unlike port wine stains) and require no treatment.
However, treatment may be warranted when a hemangioma interferes with vision or feeding, when it involves vital internal organs, when it causes overlying ulcerations, or when it grows very rapidly.
When treatment is desired (, there are several options available. Medicines, surgery, and laser therapy have all been used with success. There are some childrens’ hospitals where pediatric dermatologists and surgeons regularly work together to treat problematic hemangiomas.

How can it be prevented?

Effective prevention is not available.

Related A-to-Z Information:

Anemia (Low hemoglobin), Baby Acne, Cradle Cap, Diaper Rash, Erythema Toxicum (Baby rash), Inconspicuous Penis, Labial Adhesions, Lanugo, Milia, Miliaria, Moles (Nevi), Mongolian Spots, Port Wine Stain, Pustular Melanosis, Salmon Patches

Dr. Greene’s Answer:

Several years ago, I met a little girl who had been taken from her parents because authorities noticed that her body, especially her buttock, was covered with large, deep bruises. She and her parents were ripped from one another, for her own good. I can only imagine what they each felt. Child abuse charges were eventually dropped, when these “bruises” were correctly diagnosed as Mongolian spots.

These flat birthmarks can be deep brown, slate gray, or blue-black in color. They do sometimes look similar to bruises. The edges are often, but not always, indistinct. They are most common on the lower back and buttocks, but are often found on the legs, back, sides, and shoulders. They vary from the size of a pinhead to six inches or more across. A child may have one or several.

At least one Mongolian spot is present on over 90% of Native Americans and people of African descent, over 80% of Asians, over 70% of Hispanics, and just under 10% of fair-skinned infants (Clinical Pediatric Dermatology, 1993). Despite the name, Mongolian spots have no known anthropologic significance, except for being more common in darker-skinned infants.

Mongolian spots are nothing more than dense collections of melanocytes, the skin cells which contain melanin, the normal pigment of the skin. When the melanocytes are close to the surface, they look deep brown. The deeper they are in the skin, the more bluish they look. Either way, they are not related to bruises or any other medical condition. They do not predispose to skin cancer or any other problem.

Mongolian spots are present at birth, and most of them fade (at least somewhat) by age two. Most have completely disappeared by age five. If Mongolian spots remain at puberty, they are likely to be permanent. Fewer than five percent of children with Mongolian spots still have any by adulthood. Those who do tend to be the ones with multiple, widespread spots, or with spots in unusual locations.

If your daughter’s spot were in a very unusual location, I might suggest asking her physician to confirm the diagnosis. Since your daughter’s spot is on her buttocks, since these spots are entirely benign, and since most will disappear without trace, I would relax and wait. In the unlikely event that it is still present after puberty, there may (by then) be safe, painless, effective ways to remove them — if she should so choose.