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Congenital Mole/ Blemish/ Spots/Mark /Stain /Patch Over the Skin: Help Prediction of Future Malignancies /Cancer

A birthmark is a blemish on the skin formed before birth. They are part of the group of skin lesions known as naevi. The cause of birthmarks is unknown, but may include cellular damage due to radiation or chemicals. Some types seem to run in families.

No one knows what causes blood vessels to group together, but it's good to know that most birthmarks don't hurt at all and they usually aren't a sign of any kind of illness. Lots of newborns have these birthmarks on the back of the neck (where they're called stork bites) or between the eyebrows (where they're called angel kisses). These birthmarks usually disappear within the first few weeks or months of life.

Birthmark, pigmented maldevelopment of the skin that varies in size, either present at birth or developing later. Birthmarks may appear as moles (melanocytic nevi) that vary in color from light brown to blue, and are either flat or raised above the surface of the skin. They are usually benign, but do rarely develop into malignant melanoma, a form of skin cancer. The so-called port-wine stains and strawberry marks involve vascular tissue. The flat port-wine stains can be made lighter with the use of laser therapy.

There are various types of lesions or abnormalities of the skin. Two of the most common lesions are moles and skin tags.

A mole is a flat spot or raised lump on the skin. They vary in size and are usually darker than the skin although they can be pink colored.Fortunately, most moles are benign and harmless. Occasionally, however, one can become cancerous. Excessive sun exposure or a history of skin cancer in your family increases your risk of getting skin cancer.

Skin tags are lesions that do not become cancerous and are often confused with moles. They are usually flesh-colored and are long pieces of skin that stick out. They are not dangerous and can be left alone or, if desired, they can be removed in the office. Since a mole can be mistaken for a skin tag, any change in a skin tag should also be examined by a health professional.

Sturge-Weber syndrome is a neurological disorder indicated at birth by seizures accompanied by a large port-wine stain birthmark on the forehead and upper eyelid of one side of the face. The birthmark can vary in color from light pink to deep purple and is caused by an overabundance of capillaries around the trigeminal nerve just beneath the surface of the face.

The following are the most common types of vascular birthmarks:

Macular stains ("angel's kisses" or "stork bites") - the most common type of vascular birthmark, characterized by mild red marks that may appear anywhere on the body.
"angel's kisses" - marks located on the forehead and eyelids, which usually disappear after age 2.
"stork bites" - marks on the back of the neck, which may last into adulthood.
Hemangioma - another common type of vascular birthmark that involves different types of blood vessel growths.The hemangioma is the most common benign growth in infants. It's a collection of small blood vessels that grow rapidly in the skin during fetal development. This pink birthmark grows during the first year of life and then recedes over time. By age 10, a child who had a hemangioma in infancy usually retains little or no visible trace of the growth. Hemangiomas can be located anywhere on the body.Most hemangiomas are small, harmless birthmarks that appear soon after birth, proliferate for 8 to 18 months, and then slowly regress over the next 5 to 8 years, leaving normal or slightly blemished skin. In rare cases, hemangiomas can endanger vital structures, with a mortality of up to 60 percent. About a third of these life-threatening hemangiomas respond to treatment with corticosteroids, but for the others there is no safe and effective treatment.
Port-wine stains - a port-wine stain, also called a nevus flammeus, is a flat, pink, red, or purple mark that appears at birth, often on the face, arms, and legs, and continues to grow as the child grows.Most often, a port-wine stain appears on the face and neck, but it can affect other areas of the body. The size of a port-wine stain can vary from very small to quite large.
Mongolian spots : A Mongolian spot is a bluish-gray, flat birthmark that is found in more than 90% of American Indian, Asian, Hispanic, and black babies. They occur most commonly over the back and buttocks, although they can be present on any part of the body. They vary greatly in size and shape. Most fade away by 2 or 3 years of age, although a trace may persist into adult life.
Stork bites (pink birthmarks) : Flat pink birthmarks (also called capillary hemangiomas) occur over the bridge of the nose, the eyelids, or the back of the neck in more than 50% of newborns. Most of these spots fade and disappear, but some can persist into adult life. Those on the forehead that run from the bridge of the nose up to the hairline usually persist into adult life. Laser treatment during infancy should be considered.

In spite of the fact that congenital malformations refers defects including birthmarks on the skin, some microforms of oral clefts are under-ascertained. These include sub-mucous CP, uvula bifida, and notched gum at the maxillary-palatal junction level.

Registered birth prevalence rates per 100 000 are:

sub-mucous CP: 0.6,
uvula bifida: 1.2, and
notched gum: 1.1.

Even though some of these microforms may be unrelated to typical OCs, actual evidence is still needed, findings on congenitally “healed” cleft lip.

Study in the Collaborative Perinatal Project, 2505 individuals had a documented definite or suspected birthmark, including 7 of 47 children who developed cancer. Birthmarks were associated with a significant increase in the risk for cancer. There was a slight attenuation of the risk estimate when cases that were diagnosed in the first year of life were excluded. No specific childhood malignancies were notably affected by birthmarks.Although this study was based on a small number of cases, we found birthmarks to be in excess in children who received a diagnosis of cancer using prospective data. These findings provide additional support for the possibility of a shared etiology between birthmarks and childhood cancer that could offer insight into the pathogenesis of pediatric malignancy.

There may be an association between childhood cancer and birthmarks, according to a new study.

Minor malformations, such as birthmarks, may reflect "altered prenatal development," which could also increase the risk developing cancer, Dr. Julie A. Ross, of the University of Minnesota, Minneapolis, and colleagues point out in the medical journal Pediatrics. In addition, children with certain leukemias and soft tissue tumors have been shown to have "a significant increased frequency of birthmarks."

To further investigate this relationship, the researchers used data from a cohort for 49,503 children born between 1959 and 1966. Birthmarks were documented as definite or suspected during the first year of life and included strawberry birthmarks, port-wine stains, pigmented moles, and café-au-lait spots.

Overall, 2505 children had a documented definite or suspected birthmark. Out of the whole group, 47 children were diagnosed with cancer before age 8 years and seven of these had a definite or suspected birthmark.

When all cancers were included, having a birthmark was associated with a threefold increased likelihood of developing cancer. The team notes that birthmarks did not appear to be associated with any specific type of childhood cancer.

Because of the small number of cancer cases, it's possible that the findings could have arisen by chance, Dr. Ross's group notes. Nonetheless, they hope the results may lead to insights into the cause of childhood malignancies.

Though no treatment is needed in many of these cases, a child with a hemangiomas should be watched carefully by a doctor skilled in pediatric skin disorders. The hardest part for parents is to wait until the birthmarks begin to fade on their own or, in the case of a birthmark that does not fade, waiting until the child is old enough for surgical management.

Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp. Examine your chest and trunk, and the tops and undersides of your arms and hands. Examine both the front and back of your legs, and your feet, including the soles and the spaces between your toes. Also check your genital area, and between your buttocks.

The ABCD rule is a convenient guide to the usual signs of melanoma. Be on the look out and notify your doctor about any of the following changes to a mole or birthmark:

A is for ASYMMETRY: One-half of a mole or birthmark does not match the other.
B is for BORDER: The edges are irregular, ragged, notched, or blurred.
C is for COLOR The color is not the same all over, but may have differing shades of brown or black, sometimes with patches of red, white, or blue.
D is for DIAMETER: The area is larger than 6 millimeters (about ¼ inch -- the size of a pencil eraser) or is growing larger.

The most important warning sign for skin cancer is a spot on the skin that is changing in size, shape, or color over a period of one month to one or two years.