Encyclopedia of Health and Medicine

B
baldness
bedsore
See ALOPECIA.
See DECUBITUS ULCER.
birthmark A discoloration on a newborn’s SKIN
present at, or that emerges within a few weeks of,
birth. Birthmarks are either vascular (composed of
BLOOD vessels and red in color) or pigment (patches
of skin that differ in color from the surrounding
skin). Though some birthmarks, especially large
ones, may be permanent, many fade to become
faint or unnoticeable by about age 10 years. Most
birthmarks do not present any health problems,
though large or obvious birthmarks often arouse
concern for cosmetic reasons. Occasionally vascular
birthmarks arise in sites where they can interfere
with vision (when near the EYE or on the eyelid),
BREATHING (when near the entrance to the NOSE), or
feeding (when on the lips).
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Symptoms and Diagnostic Path
Most birthmarks are present at, or appear shortly
following, birth. Some vascular birthmarks may
not appear for several months after birth. When
this is the case, the birthmark appears suddenly
and grows rapidly, then remains at a steady size.
Many vascular birthmarks then disappear as the
child grows older. The doctor can identify most
birthmarks based on physical appearance. The
doctor may choose to conduct MAGNETIC RESONANCE
IMAGING (MRI) or COMPUTED TOMOGRAPHY (CT) SCAN
when there is a cavernous hemangioma because
this kind of blood vessel tumor (noncancerous)
can occur within internal organs such as the LIVER
or BRAIN and creates a risk for HEMORRHAGE (uncontrolled
bleeding), or the doctor may perform a
biopsy (take a tissue sample to examine under a
microscope) of lesions of questionable composition.
Multiple café au lait spots (six or more) can
suggest NEUROFIBROMATOSIS, a genetic disorder, and
require further evaluation. Congenital dermal
melanocytosis (Mongolian spot) often has the
appearance of a large bruise (ECCHYMOSIS), sometimes
raising concerns about CHILD ABUSE among
those who are not familiar with this birthmark. A
health-care provider can quickly distinguish the
mark and determine that it is not a bruise.
Any change in the size, color, or characteristics
of a birthmark, especially a
NEVUS (mole), requires prompt medical
evaluation to check for malignant
melanoma or other SKIN CANCER.
Treatment Options and Outlook
Most birthmarks fade by ADOLESCENCE, making
treatment unnecessary. The doctor may choose to
surgically remove nevi (moles) that are large or in
locations where they are subject to irritation from
clothing or movement, to prevent them from
evolving to SKIN CANCER. Port wine stains (flat
hemangiomas) are often emotionally distressing
when they occur on the face. The dermatologist
may use laser therapy to shrink and seal off the
blood vessels causing the port wine stain, diminishing
its prominence. Cover-up cosmetics are also
an option. Children are particularly sensitive
about having obvious birthmarks and may need
emotional support. Birthmarks are very common,
with some experts estimating that about a third of
infants are born with them.
Risk Factors and Preventive Measures
Birthmarks appear to be random and common,
with as many as a third of newborns having at
least one. Because researchers do not know what