Types of Birthmarks

Birthmarks are extremely common, and luckily, they’re usually harmless. It’s not clear why some people get them and some don’t, but they occur most often in Caucasian children and up to five times more often in girls. They are sometimes apparent at birth, but some types of birthmarks develop soon after. (...)

Birthmarks fall into one of two categories: pigmented or vascular. Pigmented birthmarks are a result of an overgrowth of melanocytes, the cells that regulate the pigment in our skin. Pigmented birthmarks are very common, including marks such as café-au-lait spots, moles, and Mongolian blue spots.

Café au lait spots are coffee-colored spots that can appear anywhere on the body, although the smooth, rounded marks are usually found on the torso or lower body. Some children have multiple spots, and although they don’t fade, they are usually harmless. However, if you detect several of these spots, it could potentially be a symptom of a nerve disease and you should have them checked out by a doctor.

Mongolian blue spots are curious, flat, bruise-like spots that often appear on a baby’s buttocks or lower body. This type of birthmark occurs most often in darker-skinned babies and is named for Attila the Hun, whose children were all said to carry the mark. Mongolian blue spots range in color from blue to black to grey, and almost always fade within a few years.

Moles are a very common form of pigmented birthmark. Many fair-skinned people have a multitude of moles, usually brown or black in color. People with many moles have a slightly higher chance of developing skin cancer and should take precautions when in the sun. Some congenital moles can be abnormally large, but plastic surgeons can remove them. Just removing the mole, though, doesn’t reduce the chance of skin cancer, and anyone with moles should stock up on sunscreen.

Vascular birthmarks are malformations of blood vessels and capillaries near the skin. Sometimes the vessels are abnormally wide, and sometimes there are simply too many of them, but they deliver a larger volume of blood to the affected area, causing colored marks and skin distortions.

Macular stains are also sometimes called salmon patches, angel kisses, or stork bites. They are flat-pink or red marks that comprise the bulk of vascular birthmarks. The harmless marks occur most often around the face, head, or the nape of the neck, and usually fade after childhood.

Hemangiomas can occur as either a raised mark on top of the skin or they can grow inward. They are bright red and usually raised or bumpy. Most hemangiomas are small and fade after childhood, but some can be large and leave a scar. Although hemangiomas are not usually dangerous, marks that occur near the face or head can interfere with breathing or vision, and should be monitored by a doctor. Sometimes they’re called strawberry hemangiomas because of the bumps on their surface.

Port wine stains are the most severe and distressing of birthmarks, since they are often dark red or purple, and often highly visible. Mikhail Gorbachev’s famous forehead birthmark is an example of a port wine stain, although most of these marks occur on the face. Although not life threatening, they can affect the shape of the face, since the abundance of blood flow to the area can sometimes cause the skin to become stretched or distorted. Many people with port wine stains choose to undergo laser therapy to shrink the stain, since with age, the mark can take on a pebbled texture or affect vision and speech.

Venous Malformation
Abnormality of the large deep veins, sometimes mistaken for hemangioma.Can be deep or superficial – deep can have no color but show a protruding mass.Jaw, cheek lips and tongue are most common areas affected. Soft to the touch, color disappears and empties when the lesion is compressed.When a child cries or is lying down the lesion expands and the vessels fill and the color becomes more intense.Slow, steady enlargement – it will grow – some things cause more rapid growth such as serious sickness, trauma, infection, hormone changes (puberty, pregnancy, menopause). Partial removal is not recommended, as these lesions will grow back.

Lymphatic Malformation
Excess fluid accumulates causing lymphatic vessels to enlarge. Sponge-like masses of abnormal channels and spaces containing clear fluid.Leakage from skin can occur – can lead to cellulitis. If lymph vessels in face affected, face will swell.Can occur anywhere on body but most common in head and neck area. In mouth area, looks like frog eggs.Can increase and grow with the individual.Only skilled surgeon should treat.MRI and CAT scan are used to diagnose. Laser treatment, sclerotherapy, and surgery used to treat or remove.

Cavernous Hemangioma
Bluish or bluish-red in color.Lumpy mass.Borders not visible as with other hemangiomas. Grows fast during first 6 months – then slows95% disappear by 10-12 years of age. Treatments are the same as for strawberry hemangioma.

Arteriovenous Malformation (AVM)
AVM’s are usually present at birth.Sometimes they don’t appear until adulthood. Can be acquired after direct trauma.Complex mass of veins and arteries – vessels enlarge and thicken and increased blood flow to the area results. Firm mass - when pressed feels soft and gel-like, can feel pulse or heartbeat, can cause pain.Lips, head and neck are common areas affected. Can also occur in the brain, brain stem or spinal cord.Angiography used to detect AVM.Treatment by skilled physician only – combination of embolization and surgical excision usually recommended.

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