Neonatal and Newborn Flashcards
Rarely present at birth but appear at 2yrs of age
Flat or slightly elevated – either flesh-coloured, brown or black
Very low malignancy risk unless large congenital naevi
What’s the diagnosis?
Melanocytic or vascular?
Pigmented/melanocytic naevi
Uniformly pigmented
Sharply demarcated, macular lesions that Vary greatly in size
>6 of this diagnosis with freckles under arm/around groin = feature of neurofibromatosis type 1 (genetic): genetic testing, X-ray/MRI
Melanocytic or vascular diagnosis?
Treatment?
Cafe au lait spots
No Rx required – can laser/cosmetic camouflage to conceal
Appear after birth, often < 1st month – 5% of population (esp. F, premature and multiple births)
Benign overgrowth of endothelial cells of blood vessels
Bright red – protuberant (protrude), compressible, sharply demarcated lesions – occur anywhere on skin, esp. head and neck
Bleeding may occur
Rapid growth phase after birth, followed by slower growth phase, and finally regresses and resolves spontaneously over few years
Melanocytic/ vascular diagnosis?
Treatment?
Strawberry Naevus/ superficial haemangioma
Rx: don’t intervene unless impacting function (e.g. vision), ulceration or disfigurement: education, reassurance, emollient
If any of the above, Rx to induce rapid shrinkage> Oral Propanolol (first-line), steroids or pulsed dye laser Rx
Occur in up to 40% of new-borns – present at birth
Small, pink, flat lesions
On eyelids, bridge of nose, upper lip, neck and forehead
Usually fade and disappear during infancy – although 50% of those on nape of neck persist to adulthood
Melanocytic/ vascular diagnosis?
Treatment?
Salmon patch: naevus flammeus
No treatment required
Flat, blue or slate-grey lesions in lumbar-sacral area – usually 2-8cm wide
80% of black and Asian babies
Fade during first few years
Melanocytic/ vascular diagnosis?
Treatment?
Mongolian spots: dermal melanocytosis
No treatment required
Present at birth – occur due to mature, dilated, dermal capillaries
Macular, sharply circumscribed lesions that are pink, red or purple and vary in size
On any area of skin, esp. face and upper trunk
If located to trigeminal area – consider Sturge-Weber syndrome, where there is an underlying meningeal haemangioma and intracranial calcification: can lead to seizures; if located on the eye >glaucoma
Persist into adult life, usually enlarging in proportion and becoming uneven and bumpy, bleeding if scratched
Melanocytic/ vascular diagnosis?
Treatment?
Port wine stain
Rx: pulse dye laser Rx (young children or extensive spread >up to 10 sessions at intervals of approx. 8wks), anaesthetic cream (older children), cosmetic camouflage
