Mongolian Spots - Causes and Risk

What Are Mongolian Spots?

Slate grey nevi, also known as Mongolian blue spots, are a type of pigmented birthmark. In medical terminology, they are known as congenital dermal melanocytosis. These blue-gray, flat marks are not raised. Although they frequently appear on the lower back or buttocks, they can also be found on the arms or legs. They typically exist at birth or emerge shortly after.

These birthmarks pose no health risk because they are not cancerous. But to ensure the diagnosis is correct, the child's pediatrician may check the marks. The recommended course of action for Mongolian blue spots is none, as they typically diminish before adolescence.

What Causes Mongolian Spots?

• Pigment cells that produce melanin below the skin's surface cause Mongolian blue spots. Due to a phenomenon known as the Tyndall effect, the spots seem to be blue.

• The Tyndall effect results from scattered light as it travels through nearby particles. Because they have a shorter wavelength, the pigments on the skin's surface appear in various combinations of blue, grey, and black. The precise color or hues of the mark are frequently determined in part by the number of melanocytes.

• Melanin, which causes pigmentation in the skin, is produced by melanocytes. The amount of melanin present in these cells and the depth of the spots in the dermis are additional factors that affect the color of the spots.

Who Is at Risk of the Condition?

About 90 percent of Native Americans and African Americans, 70 percent of Hispanics, 80 percent of Asians, and between 5 to 10 percent of white people have blue-gray spots. Infants of both sexes are typically affected equally, even though some studies point to a slightly higher occurrence of these birthmarks in males. Additionally, compared to preterm babies, full-term babies are more likely to have blue-gray spots.

Do Mongolian Blue Spots Pose a Risk?

There is no link between Mongolian blue spots and any illnesses or cancer. However, if the child's blue spot or spots are growing larger or more prominent, particularly close to the mouth, a pediatrician must be consulted.

A few studies have also discovered an association between lysosomal storage diseases and Mongolian blue spots, among other metabolic issues. Furthermore, studies indicate this association is more potent when numerous blue spots exist.

How Do Mongolian Blue Spots Appear?

Mongolian blue spots can be confused with bruises due to their similar hue. They are:

• Flat against the skin and not raised, with a normal skin texture.

• Blue or blue-gray in color.

• Typically two to eight centimeters wide.

• Irregular in shape with poorly defined edges.

• Usually found on the buttocks or lower back and less frequently on the arms or trunk.

Mongolian blue spots, however, don't go away quickly as bruises do.

When to Get Medical Attention?

There is nothing to be done after a blue-gray spot has been diagnosed other than to watch the spot develop over time and wait for the resolution. However, the child's doctor may be consulted if the spot does not disappear within the first few years of life. Additionally, because this birthmark resembles bruises, it is best to seek medical attention if unsure whether it was present at birth.

How Are Mongolian Spots Treated?

The blue spots typically disappear on their own for most infants between the ages of three and five. This diagnosis in infants does not require therapy or treatment because it is a benign condition that will go away on its own. However, in a few instances, large and numerous spots that continue after a year of life may be linked to uncommon genetic disorders. The child's doctor may decide to send blood to the lab for testing for specific genetic diseases if there is a family history of genetic diseases in addition to this condition.

Some people continue to have birthmarks as adults. If the birthmarks are bothersome, patients considering laser treatment for Mongolian blue spots may also want to consider wearing makeup or hiding them with clothing.

What Are the Differential Diagnoses of Mongolian Spots?

• Blue Nevi: A blue nevus is a type of benign mole. It might already exist at birth or emerge with aging. There are numerous types of blue nevi. Common blue nevi are harmless and do not change throughout a person's life. However, there is a slight possibility that a cellular blue nevus could develop into melanoma.

• Dermal Melanocyte Hamartoma: Ectopic melanocytes that persist in the dermis after birth are the hallmark of the rare clinicopathological condition known as dermal melanocyte hamartoma (DMH). It is believed to be the consequence of a defect in melanoblast migration during embryogenesis.

• Nevi of Ota and Ito: Hyperpigmentation around the eye and occasionally in the eye itself characterizes Nevus of Ota. Skin darker in some areas than the surrounding skin is called hyperpigmentation. Oculodermal melanocytosis is another name for nevus of Ota. Because it is a specific type of dermal melanocytic hamartoma, the tissues contain more melanocytes than normal, which produce melanin. Nevus of Ito is a comparable skin condition. It resembles the nevus of Ota in many ways but instead manifests on the shoulder and side of the neck. The location of involvement and distribution is the only distinction between the nevi of Ota and Ito. In the nevus of Ito, ocular complications are not observed. With menstruation, fatigue, or changes in the weather, the pigmentation intensity in both nevi can change.

• Physical Child Abuse: Skeletal injury, burns, bruising, and central nervous system damage from head trauma are all possible outcomes of physical child abuse (a non-accidental injury that a child sustains at the hands of their caregiver). The extent of the injury and the child's developmental stage and abilities must be established for the clinician to determine whether a child's injury was likely intentional rather than accidental.

Conclusion

Mongolian spots are large, flat, blue-gray lesions that frequently appear on an infant's lower back or buttocks at birth. Over time, most Mongolian blue spots subside on their own. They do not affect long-term health, like other noncancerous birthmark varieties. However, changes in the shape or color of some areas could indicate something else. A self-diagnosis must not be made of any skin issues; a dermatologist or physician must always be consulted.