Med Quizzes

Neonatal Skin Lesions: Vascular & Pigmented

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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)

Neonatal Skin Lesions: Vascular & Pigmented

Findings Bank

A Congenital Melanocytic Nevus

B Congenital Dermal Melanocytosis

C Café-au-Lait Macule

D Infantile Hemangioma

E Port-Wine Stain