Med Quizzes
Neonatal Skin Lesions: Vascular & Pigmented
A
Congenital Melanocytic Nevus
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B
Congenital Dermal Melanocytosis
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C
Café-au-Lait Macule
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D
Infantile Hemangioma
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E
Port-Wine Stain
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Neonatal Skin Lesions Cheatsheet
Key Concept:
CMN = pigmented WITH hair at birth, malignancy risk. Mongolian spot = blue-gray, sacrum, fades. Hemangioma = appears AFTER birth, grows then involutes. Port-wine = flat, dark red, permanent, V1/V2 → Sturge-Weber.
Diagnosis
Key Features
Congenital Melanocytic Nevus
Pigmented lesion with overlying hair; present at birth; may be large (>20 cm = giant)
Risk of malignant transformation (especially giant CMN → melanoma in 5-10%)
Management: serial monitoring + surgical excision (giant CMN)
Congenital Dermal Melanocytosis
Flat, blue-gray patch over sacrum; fades by age 5; nontender
No malignant potential; more common in infants with darker skin pigmentation
Management: reassurance only; document to prevent misidentification as bruising
Café-au-Lait Macule
Light-brown (café-au-lait) flat macule; ≥6 lesions + ≥5mm in children → NF1 workup
Associated with neurofibromatosis type 1 (NF1); also McCune-Albright, tuberous sclerosis
Infantile Hemangioma
Bright red, raised plaque appearing days-to-weeks AFTER birth; NOT at birth
Proliferates 0-12 months; involutes 1-5 years; beard distribution → laryngoscopy
Treatment when high-risk: oral propranolol; pulsed dye laser NOT indicated
Port-Wine Stain
Flat, port-wine colored (deep red/purple) lesion; present at birth; does NOT fade
On face (V1/V2 distribution) → rule out Sturge-Weber syndrome (leptomeningeal angioma)
Treatment: pulsed dye laser (for port-wine stain, NOT hemangioma)