How serious are the consequences of not paying attention to birthmarks on your child's skin?
This 4-year-old girl smiled and smiled, and recently began to have vaginal bleeding and breast development, which made parents panic! At first, everyone thought it was "precocious puberty", but the smile did not look fat at all, and the parents took their daughter to the hospital for examination.
As a result, the doctor said a word, making everyone dumbfounded ↓↓↓
This "brown birthmark" on my daughter
Belongs to a rare endocrine disorder!
This birthmark actually belongs to the "milk coffee spot", basically 25% to 30% of children have it! However, it generally does not exceed 1.5cm, and it grows on the face or torso, and it is not painful or itchy, so it is difficult to attract the attention of parents.
Image courtesy of Benign pigmented skin lesions other than melanocytic nevi (moles). UpToDate.2020 and: VisualDx.com
Most of them do not affect health, but this situation like laughter is an abnormal genetic syndrome:
1, coffee spots are widespread: there are 6 coffee spots on the body ≥.
2. The diameter of the coffee spot is greater than 1.5cm.
3. In addition to coffee spots, there are many nodules or lumps on the child's body.
Coffee spots with the above 3 conditions must be treated in time! In addition, there are many types of birthmarks on children, especially the following birthmarks with a high rate of cancer, parents should really understand it!
01 High cancer coefficient! Melanin nevi – a giant congenital nevus
Basically everyone has moles, especially this pigmented mole! Often the diameter is less than 4-6 mm ↓↓↓
This little guy, don't worry
But there is a kind of melanin mole that looks very "atmospheric and has a row of noodles"! The area can reach the size of a palm, or even larger; It will be thicker and more convex to the touch, and even a lot of hair will grow on it...
It is a "congenital giant nevi" that is generally larger than 20 cm in size, mainly distributed in the back half of the trunk, and also on the head or limbs, which may cover a large area of skin on the body. It is usually dark in color, and there are satellite-like lesions scattered outside the main body.
This kind of mole, the cancerous rate will be relatively high! And 5% to 10% may become melanoma [1].
If you are concerned that your mole may be at risk of degeneration, you can first do a self-examination to see if it has the following five characteristics of "ABCDE" [2].
A: Asymmetry
It is the asymmetry in the shape of the mole: whether it is up and down, or left and right. (Imagine that the lesion can be folded up and down or left and right like origami)
B: Border irregularity
That is, the edges are not rounded and curved, but there are jagged notches.
C: Color variation
Normal moles are uniform and single in color, while risky moles appear colorful black. For example, in a mole: there is black, there is brown, there is yellow, there is red, and so on...
D: Diameter over 6 mm
Moles with a diameter greater than 0.6 cm, or moles that have grown significantly in the short term, are cause for alarm.
E: Elevation
That is, the surface becomes raised or the size of the lesion increases.
In daily life, if a melanin nevus is found to have the above five points of ABCDE, it is recommended to go to the local hospital for non-invasive dermoscopy or do pathological examination to exclude melanoma.
02 Generally harmless, but still needs continuous observation
1. Hemangioma
Hemangiomas are actually a common childhood tumor and are more common in girls. Basically 2 out of 100 newborns will have this birthmark.
It looks like a red mole on the outside and bulges up on the skin! However, it is a self-limiting disease that may lessen or resolve at the age of 3 years. Medical attention is only required if these conditions occur:
(1) Hemangioma grows in high-risk areas:
Around the eyes (compression of the eyeball affects vision), face (may cause permanent disfigurement), joints (affecting walking), around the mouth or private parts such as breakable areas (repeated rubbing leads to bleeding infection).
(2) The rash is developing:
The number increases, such as in children under 6 months of age, with multiple or very large bodies (more than 5 cm in diameter).
(3) Complications: such as: infection pain, etc.
2. Vitiligo
Vitiligo has a familial genetic predisposition and the cause is currently unclear.
Head + neck, is the area most prone to vitiligo in children (31%-59%), especially around the eyes. Other common areas are the back of the hands and feet, fingers, knees, elbows, and calves.
Children with eyelid vitiligo and whitening of eyelashes[3]
However, it will not affect the growth and development of the child. In addition to affecting the appearance, it may also affect the child's psychology, and there is no feeling of physical discomfort.
Although it does not affect the normal growth of the baby, once vitiligo is diagnosed or highly suspected, a general examination should be done to rule out external concomitant diseases, and the sooner the treatment, the better.
3. Wine stains
Wine stains are a telangiform deformity that causes birthmarks that turn red or purple in the color of the skin. Commonly found on the baby's head + face, the color will become darker and thicker with age; Irregular edges, fading on pressing.
If it grows near the eyes or forehead and has a large area, be sure to do a CT of the brain to see if there are also malformed blood vessels in the skull. And such babies are often accompanied by epilepsy, such as recurrent seizures can lead to lack of oxygen in the brain.
Therefore, parents must pay attention to this kind of birthmark /mole, and it is best to take the baby to the hospital in time to deal with it!
03The risk of cancer is very low! Don't worry
1. Mongolian spots:
Mongolian spot is a very common birthmark, occurring in about 86.3%. Parents can rest assured that the vast majority of children will disappear by the age of 3 to 4 years without a trace.
Most often occur in the baby's waist, sacro tail and back, and find a little grayish blue, dark cyan spots. It is mainly round, oval or square, but the realm is not very obvious.
If it disappears naturally in childhood, this indicates a good skin change! And so far, there have been no reports of malignancy of The Mongol spot. It is worth mentioning that most of these plaques are congenital, so they cannot be prevented in advance and can only fade naturally.
2, Ota Tsunagi:
Ota nevi may be genetically related and is most commonly found in the periorbital, temporal, nasal, forehead, and cheekbones.
It is similar in color to the Mongolian spot , and can be grey-blue , bluish-gray , gray-brown , black, or purple , with unevenly colored patches , spotted or meshed , with unclear boundaries. (It is generally brown-spotted or mesh-like, while blue is more diffuse.) ）
The main difference between the two is that it cannot disappear on its own, but it is rarely malignant and can be improved by professional laser treatment.
3. Non-pigmented nevi:
Pigmented nevi is not as pronounced as vitiligo white, the realm is blurred and irregular, sometimes the edges are jagged, and there is almost no pigmented proliferation halo around it.
Usually present at the time of birth or within a few months of the baby's birth. This is a unilateral, localized hypopigmentation spot. This condition is associated with decreased melanocyte function, which can cause local skin tone to be lighter than the surrounding color.
This is a benign birthmark that does not require treatment. It's just that parents need to pay attention: because of the decrease in pigmentation, this part of the skin will be more sensitive to ultraviolet rays, so pay attention to the sunscreen of this piece every day. (Block out the sun or apply sunscreen)
Finally, I would like to tell parents that no matter what kind of birthmark, in the process of active treatment, they must also learn to accept and praise their children. Many times, compared with the harm of the birthmark itself, the collapse of the child's mentality is a major event that destroys the world!
Resources:
[1] Burd A. Laser treatment of congenital melanocytic nevi. Plast Reconstr Surg. 2004;113(7):2232–3.
[2] National Health Commission, Melanoma Diagnosis and Treatment Guidelines (2022 Edition)
[3] Nicolaidou E, Mastraftsi S, Tzanetakou V, Rigopoulos D. Childhood Vitiligo. Am J Clin Dermatol. 2019 Aug;20(4):515-526. doi: 10.1007/s40257-019-00430-0. PMID: 30911977.