The 4 MOST common birthmarks// Neonatologist reviews// NCLEX 8

Hello, welcome to Tala Talks in a Queue. Today we are going to be talking about neonatal birthmarks. Babies can be born with all sorts of interesting birthmarks on their skin, and it's really important that you evaluate it, and even if you don't know what it is, make sure that you document it. I mean, I can't even tell you how many times I've been carefully inspecting one area of the skin, wondering what it is, and then somebody comes over and they're like, oh, that's just a drop of blood or something, so whatever it is, make sure that it's carefully inspected and carefully documented. Let's start by talking about stalk bites or angel kisses, which you've all seen on newborn babies. Basically what they are is just pale pink or red dilated capillaries, so they're macular birthmarks, which means that a macule is that you can't feel it. If you close your eyes, then it's flat with the skin. Usually we see these on the eyelids, on the nose, and on the nape of the neck, so like right below the hairline. Normally these birthmarks blanch, which means that if you press down on them, then they'll go white, and normally these birthmarks are a lot more visible when the babies are crying, and normally they kind of go away altogether by the time the babies are two or three years old. Completely benign birthmarks. Another really common birthmark is something that we used to call Mongolian spots. Now, more recently and more appropriately, they're called congenital dermal melanocytosis, and these are, that you've all seen, the kind of blue-gray macular lesions, which again, a macule means that it's not raised. If you close your eyes, you won't be able to feel it at all, but these are blue-gray lesions, which are kind of not very well defined. Most commonly, they're on the sacral area or the lower back area, but they can be everywhere. They can be on the trunk and the limbs as well, and sometimes they can almost look like there's bruising. So again, make sure that you document these, however common they are. These normally disappear within the first couple of years of life. Another pretty common birthmark is something called a strawberry nevus or an infantile hemangioma, and basically that's just a collection of blood vessel raised above the skin. So it's not a macule, it's raised above the skin. These are especially common in preterm babies, but they may take days or weeks to appear and then to get bigger, like literally in front of your eyes. They are raised bright red and really well delineated, and they kind of look like a tiny little strawberry on the baby's skin. Normally, these strawberry nevi continue to get bigger, like sometimes, like I said, in front of your eyes until the baby is about one. Then they kind of like stay about the same size and start to regress eventually until they go away completely by the time the baby, the kid, really at that point is about 10. Sometimes these birthmarks are actually on the face, and if they are near the mouth or the nose or the eyes and they're actually affecting function, then we may choose to treat them because we don't want the babies to be scarred for life. So we may choose to give the babies propranolol, which is a beta blocker, which is extremely effective at reducing the size of the strawberry nevus. Port wine stains are another type of birthmark. These are also called nevus flamus, and as opposed to the three remaining birthmarks that we talked about, these don't go away by themselves. They also can be considered quite dangerous because they may indicate that there's an abnormality beneath the birthmark. The port wine stains are basically an abnormal collection of capillaries below the skin, and so it can look like a kind of purpley blue color below the skin. They are flat and purpley, and unlike the other ones, they don't go away so that they can carry on getting bigger, and depending where they are on the body, they can be very disfiguring for patients, and a lot of times, as patients get older, they choose to get them lasered away. If the port wine stain is really big and covering the face and the eye, then we're really concerned that these blood vessel abnormalities are going all the way back into the brain. This would be called Sturge-Weber syndrome, so if there is a big port wine stain covering a significant part of the face, then we should get an MRI of the brain and make sure that it's just superficial and there's nothing, anything concerning deeper going on. All right, learn all of those. You're definitely going to have to know them. You'll probably see all of them very soon in your career, so for now, thank you for being here, and go on and watch the next video on the abdominal exam.