Q. One of my twin girls has big hyperpigmented spots on legs and arms. Could this be Cafe Au Lait?
Hello doctor,
We have identical twin girls who are six years old. Both have hyperpigmented spots, but one of them has more than the other and a bit larger. They are tan, a little indistinct, and several with ragged edges. We have been able to identify seven spots. It appears they have darkened as we have not noticed several of them in prior years. Their pediatrician has never said anything regarding the spots. I have attached the pictures and circled the areas. These are specified on her legs and arms. None are located on her trunk, face, neck, or buttocks. I also included a family picture, showing the differences in our pigmentation. Now that we have noticed these, my partner and I are very concerned that these could be a sign of NF1. She does not have any freckling spots in her inguinal, neck, or axillary areas. The only freckles she has are on her cheeks and nose, like her sister. The girls have their annual check-up next week, and we have set a subsequent dermatologist appointment for next month, to be sure. The girls did have their first eye doctor appointment several months ago, and the optometrist stated everything looked great. Could the hyperpigmentation be due to our contrasting pigmentation? I am a redhead myself, and my wife has a much darker complexion. I have a couple of hyperpigmented ragged spots on my leg, as well, but none as large as hers. Do these spots concern you for further evaluation of NF1 and Cafe Au Lait.
Hello,
Welcome to icliniq.com.
It is a prototypical benign melanocytic nevus, which is acquired nevus due to excess sun exposure. It is a benign growth on the skin, usually tan, brown color that contains a cluster of melanocytes. It may disappear with advancing age. Avoid long term sun exposure. Severe sunburn at early age, being fair skin are risk factors leading to melanoma in later life. Avoid repeated exposure to radiation or UV radiation. Avoid frequent exposure to certain chemicals. Avoid midday sun. Use sunscreen lotion even on cloudy days. Wear protective clothing that protects your arms and legs. Self-examination is needed to look for a change in shape, size, color, and margins. If detected early, it can be treated quickly with less scarring. Photostable sunscreen four-hourly even indoors for ten days and 30 minutes before going outdoors. Is there a family history of melanoma or many moles on the body or dysplastic nevi and can you get a prescription filled from the dermatologist? Please reply.
Thank you doctor,
So you do not think these seven spots are Cafe Au Lait NF spots? We do use high-grade sunscreen at all times for them. She has not been sunburned, and we are very cautious, but her skin does get tanner in the summer with 20% zinc oxide sunscreen. Some of these spots seem to be there from birth and have darkened in her six years of life. Could it just be that she is prone to hyperpigmentation (like me) since she is a redhead and fair skin with a darkly pigmented mother? So these are not CALs, but you think they are benign melanocytic nevus?
Hello,
Welcome back to icliniq.com.
Yes, the lesions are benign melanocytic nevus. It is a common occurrence and mostly harmless. No, it is not cafe Au late NF spots. They usually occur on trunk (back) most common sites, and systemic complications occur, including neurological involvement. It is not NF. So do not worry. Do self-examination of the lesion. If any change present, it needs to be reported.
Was this answer helpful?
|Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
Related Questions:
My son has a small epidermal nevus. Should I worry about potential gene mutation?
.. epidermal nevus is very common and does not pose any kind of serious health concern. Neither is a biopsy required. You are right. Any associated symptom should have been present since birth or early childhood in this case. Read full
Does a flat brown spot with flaky edges indicate melanoma?.. brown patch is cafe-au-lait macule and the small one is probably an atypical nevus (attachment removed to protect patient identity). That is not melanoma clinically to me. Melanoma is very rare at a young age like in your case and obviously very rare i Read full
What should I do to reduce the hyperpigmentation and dark circles under my eyes?I am using Bepanthen and sunscreen ... Use a broad-spectrum sunscreen throughout the day ... Read full
Also Read Answers From:
Comprehensive Medical Second Opinion.Submit your Case
iCliniq's FREE Newsletters
Expert-backed health and wellness information, delivered to your email.
Thank you for subscribing to our Newsletters!
Also Read
PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions. Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this. Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades. Read more»
Ask your health query to a doctor online?
Ask a Dermatologist Now* guaranteed answer within 4 hours.