Kids Health Information : Congenital dermal melanocytosis

Congenital dermal melanocytosis (formerly called Mongolian blue spots) are a type of birthmark. The
term congenital dermal melanocytosis refers to one or more birthmarks.They are flat blue or blue/grey spots with an irregular shape that commonly appear at birth or soon after.

Although they may look like bruises, it is important to recognise that congenital dermal
melanocytosis are birthmarks, not bruises

Congenital dermal melanocytosis are most common at the base of the spine, on the buttocks, back and shoulders.  They are extremely common among Asian children, as well as children with dark skin, including people of Polynesian, Indian and African descent.  

Signs and symptoms of congenital dermal
melanocytosis

• Congenital dermal
  melanocytosis are bluish to blue-grey spots, which may resemble bruising.
• The coloured area feels the same as normal skin to the touch.
• They are most commonly found at the base of the spine, on the buttocks and back, and may cover a large area of the back.
• Occasionally the spots can appear elsewhere on the body, like the shoulder. These tend to persist and
  are less likely to disappear.

If your child has congenital dermal
melanocytosis, they are otherwise healthy. The birthmarks are not associated with any other medical symptoms or illnesses, and do not cause any pain.

Treatment for congenital dermal
melanocytosis

No treatment is needed or recommended. The spots do not cause any medical complications. The discolouration often fades within the first years of
life, and the birthmarks have usually gone once the child reaches adolescence. Less than 3 per cent of cases will continue into adulthood, and these are
usually the ones present in body sites
other than the buttock and spine areas.

When to see a doctor

Most cases of congenital dermal
melanocytosis do not need to be seen by a doctor, unless there is some doubt as to the type of mark your child has. If the spots are particularly large, growing or located near the mouth, then these should be reviewed by a paediatrician or paediatric dermatologist (skin
specialist).

Key points to remember

• Congenital dermal
  melanocytosis are a type of birthmark, with flat blue or blue/grey spots.
  
• They may resemble bruises but they are not bruises, they are birthmarks.
  
• There are no medical complications associated with congenital dermal melanocytosis. 
• No treatment is needed – they will usually go away by the time the child reaches adolescence.

For more information

• See your family doctor, paediatrician or dermatologist.

Common questions our doctors are asked

How can I tell if it’s a bruise or a congenital dermal melanocytosis?

Congenital dermal melanocytosis and bruises do look very similar, and
the birthmarks are often mistaken for bruises. However, they are different in a
few ways. Bruises change colour, size and shape over the course of just a few
days, while congenital dermal melanocytosis stay the same for many years. Also, congenital dermal melanocytosis are not painful when touched. Congenital dermal melanocytosis are present from
birth.

What can I do if my child’s congenital dermal melanocytosis is very
prominent and is causing them embarrassment? Is laser treatment an option?

We do not recommend any treatment for congenital dermal melanocytosis, as it is unnecessary because the birthmarks will fade over time on
their own. Treatment, such as laser therapy, may cause side effects, including
infection and scarring.

Developed by The Royal Children’s Hospital Dermatology department. We acknowledge the input of RCH consumers and carers.

Reviewed August 2020.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit

www.rchfoundation.org.au.

Mongolian blue spots Information | Mount Sinai

Mongolian spots; Congenital dermal melanocytosis

Dermal melanocytosis is the name of a kind of birthmark that is flat, blue, or blue-gray. They appear at birth or in the first few weeks of life. Dermal melanocytosis was formerly called Mongolian blue spots.

Mongolian blue spots are flat bluish- to bluish-gray skin markings commonly appearing at birth or shortly thereafter. They appear commonly at the base of the spine, on the buttocks and back and also can appear on the shoulders. Mongolian spots are benign and are not associated with any conditions or illnesses.

A newly born infant is also called a neonate.

Causes

Dermal melanocytosis is common among people of Asian, Native American, Hispanic, East Indian, and African descent.

The color of the birth mark is from a collection of melanocytes in the deeper layers of the skin. Melanocytes are cells that make the pigment (color) in the skin.

Symptoms

Dermal melanocytosis is not cancerous and are not associated with disease. The markings may cover a large area of the back.

The markings are usually:

• Blue or blue-gray spots on the back, buttocks, base of spine, shoulders, or other body areas
• Flat with irregular shape and unclear edges
• Normal in skin texture
• 2 to 8 centimeters wide or larger

Dermal melanocytosis is sometimes mistaken for bruises. This can raise a question about possible child abuse. It is important to recognize that dermal melanocytosis is a birthmark, not bruises.

Exams and Tests

No tests are needed. The health care provider can diagnose this condition by looking at the skin.

If the provider suspects an underlying disorder, further tests will be done.

Treatment

No treatment is needed when dermal melanocytosis is a normal birthmark. If treatment is needed, lasers may be used.

Spots may be a sign of an underlying disorder. If so, treatment for that problem will likely be recommended. Your provider can tell you more.

Outlook (Prognosis)

Spots that are normal birthmarks often fade in a few years. They are almost always gone by the teen years.

When to Contact a Medical Professional

All birthmarks should be examined by a provider during the routine newborn examination.

DiBiagio JR Lloyd MC, Dermatology. In: Kleinman K, Mcdaniel L, Molloy M, eds. Harriet Lane Handbook. 22nd ed. Philadelphia, PA: Elsevier; 2021:chap 8.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Melanocytic nevi and neoplasms. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews’ Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 30.

McClean ME, Martin KL. Cutaneous nevi. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 670.

Last reviewed on: 4/14/2021

Reviewed by: Elika Hoss, MD, Senior Associate Consultant, Mayo Clinic, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Mongolian spot and neoplasms | Dobromed

The Mongolian spot in a newborn can be detected immediately after birth.

It appears as lesions with gray-blue or blue-black pigmentation of the skin. As a rule, it is located in the lumbosacral region, but can be anywhere, such as the lower legs, forearm, and even under the nails. Their other name is “sacred spot.” It can be seen in 90% of babies of the Mongoloid race. In Caucasians, it is observed in only 1% of babies and is usually characteristic of racial mixing in previous generations.

Causes of appearance

Human skin consists of 2 layers: dermis (corium) and epidermis. Its color depends on the location in the epidermis of pigment cells called melanocytes. Violations of their function can provoke various skin diseases, for example, Setton’s nevus, vitiligo. In Caucasians, melanin is synthesized little and only under the influence of UV rays of the sun, melanocyte activity is observed, which leads to tanning. In representatives of the black and Mongoloid race, they synthesize pigment regularly , this is what explains their skin color. During embryonic development, melanocytes move from the ectoderm to the epidermis. Scientists believe that the sacral spot appears due to the fact that this process remains incomplete and the melanocytes remain in the corium. It is their synthesis of pigment in the dermis that explains the appearance of blue-gray areas on the body. It turns out that the cause of the formation of foci of pigmentation on the skin is a slight violation of the development of the embryo associated with the presence of a specific gene. Signs of the Mongolian spot The Mongolian spot is a congenital nevus and is similar in appearance with hematoma. Most often it is blue-gray, but it can also be blue-black. It is characterized by a uniform color of the entire focus of pigmented skin. The spot may be oval or round. But usually it has an irregular shape. The size of the nevus can vary significantly. Some are small up to 1 cm in diameter, others are large up to 10 cm in size. Sometimes the entire back and buttocks are pigmented. Usually the spot is localized in the sacro-lumbar region. But it happens that it is found on the back, arms, legs and other parts of the body. Sometimes it “migrates”: over time, it changes its location, for example, it rises from the buttocks to the back. Most newborns have one Mongoloid spot on the body, but it also occurs many areas of pigmentation. At birth, it has a bright color, after a while the nevus turns pale and disappears completely by the age of 5. It happens that pigmentation disappears only in adolescence, and if there are several colored foci and they have atypical localization, then they can be observed throughout life .Differential diagnostics If there is a newborn Mongolian spot on the body, it must be shown to a dermatologist. He must conduct a differential diagnosis that allows you to distinguish the sacral spot from other types of nevi, especially those that can degenerate into melanoma, such as:

• nevus blue;
• Nevus of Ito;
• Becker’s nevus;
• borderline pigmented nevus.

When diagnosing age spots that can provoke melanoma, the child should be observed by a dermatologist and an oncologist.

biopsy – a piece of pigmented skin is taken for further histological examination, normally there should be no melanocytes in them.

Therapy

If the areas of pigmentation are Mongolian spots, no treatment is necessary. The child does not need further specialist supervision: pigmentation does not cause him any discomfort and usually becomes almost invisible by the age of 2, and completely disappears by the age of 5.

Prognosis and prevention measures

Sacred spot is not a disease, therefore no preventive measures are required. When diagnosing the Mongolian spot, the prognosis for life and health is favorable. .Therefore, no therapy for the Mongolian spot and registration with a dermatologist is required. As a rule, in most cases, such foci of pigmentation disappear on their own after a while, unlike such a pathology as albinism, which occurs due to the congenital absence of melanin pigment. Even if the sacral spots persist for life, they do not carry any harm to health, they do not pose a threat to life and do not cause discomfort to a person.

“Medal” on the buttocks, or why “Mongolian spots” are dangerous – Caravan

Gray-blue pigmentation on the skin of children of the first years of life in our region is very common. For those who have never experienced such a phenomenon, it can cause the most controversial thoughts – including that the child is bruised. In fact, doctors consider bluish markings in Asian children to be quite harmless, with rare exceptions.

Doctors explain the phenomenon of such a spot or their accumulation by the concentration of melanocytes – cells that produce pigment in certain areas of the skin. The spot can be both congenital and appear in the baby in the first weeks – months of his life. Sizes vary from a few millimeters to more than 10 centimeters, and it can be either a single irregularly shaped spot or a whole galaxy of such formations. The spot area is smooth, does not rise above the skin and looks very much like … a huge bruise. This is a kind of birthmark – from light gray to dark blue and almost black in color, which has an amazing property to disappear naturally.

The spot brightens as the child grows and disappears completely at some point. The area in its place becomes identical to the color of the baby’s skin. It is believed that not a single case has been recorded for blue spots to degenerate into malignant formations. Therefore, parents can exhale, in addition to the fact that the stain may have an aesthetically unsightly appearance, especially if it is saturated in color and located on prominent areas of the skin – legs, arms. By itself, it does not pose a danger to the health of the child. Not in the present, not in the future, with rare exceptional cases.

Scientists have determined that the presence of a spot is nothing more than a sign of belonging to characteristic ethnic groups. Not only Kazakh children are born with such spots, but also Korean, Chinese, Japanese, Mongolian, Yakut, Buryat, peoples of Southeast Asia, East African, Latin American, etc. Unscientific theories of the origin of the “Mongolian spot”, which along with this are called “Turkic”, “sacred”, coccygeal, as well as the “stain of Genghis Khan” (allegedly the conqueror himself passed this mark to his descendants) or “Tengri slap” – this is how the heavenly deity blesses the newborn. Among the Eastern peoples, its presence is considered a very favorable sign, 5 years ago in Japan there was even a meeting between geneticists and anthropologists on the topic of the “Mongolian spot” phenomenon.

Both boys and girls suffer

– It is believed that “Mongolian spots” occur only in Asian children, is this true and what is the reason?

– 80 percent of the children under 2 years of age that I see have “Mongolian spots”. But, as a rule, parents had already studied the problem on their own by that time, and questions arise extremely rarely – what is it and when will it pass, – says Sergey ISAKOV, a dermatovenereologist of the highest category. – “Mongolian spots”, or how to say it correctly – “congenital dermal melanocytosis”, do appear more in people with a dark skin phototype. This is, as a rule, a Mongoloid race, which is why they, in fact, are called “Mongolian spots”, however, they are also found with a light skin type. Either their appearance is spontaneous, not due to anything, or it is a genetic manifestation of the fact that somewhere in previous generations, in the genus of this child, there were representatives of the Mongoloid race.

– Are they more common in boys or girls?

– There are no clear descriptions of the distribution by sex, both boys and girls are equally affected.

– What are their main locations on the body?

– This is the waist, buttocks and back. If the spots spread somewhere further, then you need to see a doctor. Because it can be a signal of some metabolic disorders.

Absolutely harmless?

– Do they pose any danger to the baby’s health?

– No, they do not, they are observed on the child’s body, as a rule, during the first 2 years of life, occasionally up to 5 and extremely rarely remain in adulthood. Sometimes “Mongolian spots” can exist for a longer time – more than 5 years, or have a strong spread on the skin, then in this situation it may be a sign of some disease. But if the location is classic (buttocks, lower back, back), then this, as a rule, does not oblige you to anything. You can find out more information on childhood skin diseases on my Instagram page @dr.issakov.

– Do they need any special care?

– “Mongolian spots” do not require any specific care, supervision, except for adequate care for the baby, which should be done in all children according to age. You need to watch and monitor the condition of the child as a whole. If these spots do not go away after 5 years and increase in size, then you should consult a doctor.

– Is it possible to sunbathe with them, expose them to the sun?

– In general, in principle, I do not recommend sunbathing. Because sunburn is the production of melanin, a protective reaction of the body to ultraviolet radiation. But at the same time, if you sunbathe adequately, in small doses (in the morning before 11 and in the evening after 17.00, when the sun is very soft), then a little sunburn is acceptable.