What is a birthmark?
A birthmark is a persistent mark on any part of the skin, visible at birth or shortly thereafter (in weeks) ( 1 ). Represents local accumulation of sin pigment, overgrowth of vessels or other local skin abnormalities. Some birthmarks disappear, partially or completely, within a few years, but others persist throughout life and may even become more pronounced over time.
Most birthmarks are painless and harmless, but some can cause complications such as pressure on other organs, may be related to congenital diseases, or may rarely develop into cancer, so they always need to be checked by a doctor. Pigmented skin tags that are not birthmarks may be the result of trauma.
What is a nevus?
A nevus (plural nevi) is a persistent circumscribed mark that appears at birth or at any time in life , anywhere on the skin or mucosa of the mouth, but not due to external causes ( 2 ). Represents localized excess or deficiency of connective tissue of the skin, glands of the skin, vessels or nerves. It may appear as:
- a discoloration (pink, red, violet, bluish, brown, gray, black, or whitish or otherwise pale) at the level of the skin , a few millimeters (macula) to several centimeters
- a raised (papule, plaque) or depressed mark , color of the skin or discolored in the skin
What is a mole?
One mole is any pigmented lesion on the skin, appearing at birth or later ( 3 ). Moles include flat nevus and raised pigmented masses.
What is hemangioma
A hemangioma is a collection of small blood vessels that appear as a pink or red birthmark on the forehead, eyelids, above the nose, above the upper lip and the so-called “stork bite” on the nape of the neck. These marks disappear or disappear completely within a few years. Hemangiomas that are not birthmarks may appear later in life due to trauma or various diseases.
Below, various types of birthmarks ( 4 ) are described.
Arteriovenous Malformation (AVM)
AVMs are abnormal clusters of veins and arteries, appearing anywhere on the skin (commonly on the lips, head, or neck) as soft, gelatinous lumps that are sometimes painful under pressure.
Pictures of arteriovenous malformations (AVMs)
AVMs may also appear in the brain, brain stem, or spinal cord; they can be detected by angiography.
AVMs are usually present at birth but sometimes do not appear until adulthood and can also result from trauma.
- Surgical Removal
- Before surgery, a substance that coagulates (clogs) the vessels can be injected into the hemangioma, which causes it to contract
Coffee in sight
Pale, pale to light brown (French Café au lait = coffee with milk) patch, few to several centimeters in size, can be found anywhere on the body. Several (three or more) spots speak of neurofibromatosis.
Figure 1. Coffee with milk on the cheek
(the light brown spot to the right of the coin)
(source: Wikimedia )
The bluish-red or bluish-stone with no sharp edges grows rapidly during the first 6 months, then slows down and disappears at 10-12 years of age in most cases.
The treatment possibilities are the same as for the strawberry hemangioma.
Nevi pigmented congenital
They appear as pale hairy moles to dark browns, few to several centimeters in size. Big snow can become evil.
The infantile hemangioma , or simply hemangioma , appears at birth (or up to 4 weeks after birth) as a flattened and reddish patch with sharp edges, or embossed, soft, painless mass, a few centimeters in size, on the forehead, face, lips and baby’s neck. , or rarely on other sites, such as in the sole of the foot. Deep hemangiomas may appear as soft nodules covered with normal skin.
Figure 2. Infant hemangioma
(source: atlasdermatologic )
Pathology . The hemangioma represents an abnormal overgrowth of vessels within or under the skin.
Diagnosis . Deep hemangiomas do not require any testing, deep hemangiomas may require magnetic resonance imaging to determine their relationship to other organs.
Treatment . Surface hemangiomas generally do not require treatment, deep hemangiomas may require surgical removal , disruption of feeding, vision, or hearing.
Prognosis . The hemangioma can grow for about 1 year, then begins to decrease in size and disappears completely between 5 and 12 years of age.
Abnormalities in the lymphatic vessels can obstruct the flow of lymph which then presses the walls of the lymphatic vessels, thus causing its enlargement. Sponge-like masses containing clear fluid may appear under the skin; the fluid can leak from the vessels, causing inflammation and swelling of the skin – cellulite , most often in the region of the head and neck. In the mouth it looks like frog eggs.
The diagnosis is with MRI and computed tomography.
- Laser treatment
- Sclerotherapy – Injection of substance will clog vessels and result in shrinkage
- Surgical Removal
Blue or gray-slate discoloration, which resembles bruises , commonly appears in infants of African, African-American, Mediterranean, Asian, or Indian descent. They appear mainly on the trunk or legs.
Treatment is usually not necessary , as stitches usually disappear over time.
Port wine stain or Nevo Flammeus
Red or purple spots , flat or slightly raised, found anywhere on the body at birth. Nevi are permanent.
- Laser treatment can reduce color and prevent the growth of nodules on the lips, gums and other tissues.
Patch of salmon or simple nevus
Salmon colored nevus (“angel kiss” or “stork bite”) is most commonly found on the nape of the neck, but also on the forehead, upper eyelids, and around the mouth and nose. In most cases, it disappears completely over time.
The soft, lumpy red nodule built from abnormal vessels may be present at birth or in the first few weeks following. It can continue to grow for some time but then turns gray and disappears completely between the ages of 5 to 10 years.
Figure 3. Hemangioma in strawberry
(source: Wikimedia )
Treatment is indicated in large lesions or where it disturbs the function of other organs. Treatment options:
- Surgical Removal
- Compression and Massage
- Laser Therapy
- Cryotherapy – injury freezing
- Injection of steroids or hardeners
- X-Ray Irradiation
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A soft, bluish or skin-colored lump containing abnormal veins is present primarily at birth in the jaw, cheek, lips, or tongue. Both the mass and the color disappear when the lesion is compressed. When the baby cries, the color becomes more intense.
Image of venous malformation (venous lake on the lip)
Image of spider nebula (angioma) (often seen on the face or chest in liver disease and other disorders)
Birtmarks may be a sign of a congenital disease:
- Cutis Marmorata Telangiectatica congenita may be present with excessive growth of a limb, increased intraocular pressure (glaucoma), thin skin and neurological abnormalities.
- Osler-Weber-Rendu syndrome . Nevis represent lack of capillaries between arteries and veins.
- Kasabach-Merritt syndrome. Brownish-red discolourations and impaired coagulation bleeding appear as tufted angioma.
- The Klippel-Trenaunay syndrome presents Porto wine stain on the limbs and limb augmentation.
- Neurofibromatosis is present with multiple coffee-to-milk spots , tumors of nerves, especially in the head and mouth. It is a genetic disorder and can appear anytime and anywhere in the body.
- PHACE syndrome is present with posterior fossa cerebral malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects and ocular abnormalities.
- Sturge-Weber syndrome is present with port wine stains on the face and angiomas in the soft-brain membrane (meninges). Other symptoms are headaches , seizures, glaucoma and mental retardation.