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BIRTHMARK BASICS

Hemangioma

Hemangioma

One in ten babies is born with or develops birthmarks. Here are the facts on the six most common kinds.

Café-au-lait Spot

What it is: A beige or brown flat, oval patch caused by increased pigment in the skin’s surface layer. It can be present at birth or appear within a week or so afterwards.

When to worry:Six or more spots that are larger than a half inch should be evaluated. “That could be a sign of von Recklinghausen’s Disease,” says dermatologic surgeon Robin Ashinoff, MD. This neurological genetic disorder can put pressure on nerves, impairing normal functioning.

Treatment: Laser therapy is an option. Results vary.

Congenital Pigmented Nevi

What it is:Groups of cells produce pigment near the surface and in deeper layers of the skin. The mark can be as small as a pinhead-size mole or as large as a baby’s entire midsection and is usually raised, dark and sometimes hairy. It appears at birth or several months later.

When to worry: With pigmented nevi
comes a 5-10% greater risk of malignant melanoma. The bigger the marks, the greater the risk. Massive pigmented nevi can be psychologically damaging.

Treatment: Small pigmented nevi can be cut out in the doctor’s office. Larger ones can be surgically removed.

For More Info

For a resource list of hemangioma and port wine stain specialists in your area, log onto The Vascular Birthmarks Foundation.

For the names of area pediatric dermatologists, visit the American Academy of Dermatology.

Hemangioma

What it is: A collection of abnormal blood vessels near or just below the skin’s surface, sometimes called a strawberry mark. It usually appears a few months after birth as a cluster of flat, pimple-sized red spots that proliferate, becoming spongy, blistery masses. After about 18 months, hemangiomas start to shrink, and are usually gone by ages 3 to 10. They are five times more common in females and 80% occur on the head or neck.

When to worry: A hemangioma that’s on or near the nose, mouth or chin should be treated promptly. If a child has six or more, see a specialist. “The more a child has, the higher the risk that some may involve internal organs,” says facial plastic surgeon Marcelo Hochman, MD.  Experts also advise removal if a hemangioma is disfiguring.

Treatment: Superficial hemangiomas are treated with high doses of oral or injected steroids or faded with repeat courses of pulsed-dye laser therapy. Surgery may be needed if they involve deep tissue or affect the nose, eyes or mouth.

Mongolian Spot

What it is: Melanin (brown skin pigment) is trapped in the mid-layer of the skin. The patches appear as a bluish or grayish bruise on the lower back or
buttocks. They are common among non-Caucasians.

When to worry: They present no medical threat. Most fade totally by age 5.

Port-Wine Stain

What it is: A collection of abnormal small veins near the skin’s surface that appear flat and reddish at first. In time, the veins become more engorged with blood and the “stain” may become cobbled-looking and deeper red or purple. Port-wine stains usually get thicker and darker with age.

When to worry:A port-wine stain that involves at least one upper eyelid and the forehead may signal Sturge-Weber
Syndrome (SWS). Children with SWS are at high risk for glaucoma, seizures and delayed development.

Treatment: “Most children need six to eight pulsed-dye laser treatments to lighten or remove the superficial component of a port-wine stain,” says pediatric craniofacial surgeon Frank Vicari, MD. Results can range from no change to complete disappearance.

Stork Bite / Angel’s Kiss

What it is: A type of hemangioma. When the patch is flat, pink and on the nape of the neck, it’s called a stork bite. A patch on the forehead is known as an angel’s kiss.

When to worry: They are harmless, often barely noticeable. An angel’s kiss usually fades by age 2; a stork bite may never disappear, but it’s usually light or hidden by hair.

Treatment: An angel’s kiss that doesn’t fade may be lightened with laser therapy.

Sandra Gordon is a freelance writer.

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