Definition

Mongolian spot is a type of pigmented birthmark. These marks are flat and blue or blue-grayish patches on the skin. They’re generally present at birth or develop soon after. The spots usually appear at the base of the spine, on the buttocks and back, and can also appear on the shoulders, but rarely on the head and face. Mongolian spots are harmless skin disorders and are not associated with any condition or disease. Mongolian spots usually disappear by the age of about 3-5 years, but they can remain into adulthood.

Mongolian spot is a type of "birthmark" that is often also known as congenital dermal melanocytosis and slate gray nevi. These marks are much more likely to occur in babies of African, Asian, Indian, and Mediterranean descent, hence the name "Mongolian" spot. However, it can still occur in infants with lighter skin.

Mongolian spots are sometimes mistaken for bruises because they have a similar appearance: a grayish-blue color, irregular shape, and a flat texture. However, unlike bruises, Mongolian spots are completely painless and do not change color or shape quickly like bruises often do. Some Mongolian spots are small, while others can measure 7 cm or more.

Causes

Mongolian spots can usually appear on the skin at birth or develop soon after. The spots occur as a result of melanocytes (cells that produce skin color pigment or melanin) that remain in the deeper layers of the skin during fetal development. Under normal circumstances, melanocytes will migrate to the upper skin layers. The exact reason why melanocytes remain in the deeper layers of the skin is still unclear.

The amount of melanin (the substance responsible for skin color) you have generally determines the color of the Mongolian spot. Based on the Tyndall effect, melanocyte cells in the lower layers of the skin with their brown pigment will give the skin surface a grayish-blue color. The Tyndall effect describes a phenomenon where colors with shorter wavelengths, such as blue, are reflected at a shallower level in the skin, resulting in patches that look like Mongolian spots. Patients with darker skin will tend to have darker birthmarks as well.

Risk Factor

The risk of Mongolian spot is increased in babies born to certain races. The condition is still most common among Asian children and in those with darker skin. Some of these groups include the children of Polynesian, Indian, and African descent.

On average, only about 10% of Caucasian infants have Mongolian spots. These spots are found in about 50% of Latinos and 90% to 100% of Asian and African populations. There is no influence of gender on the incidence of Mongolian spots.

Symptoms

Mongolian spot symptoms are usually spots that appear when the baby is born or in the first few weeks of life. A baby can also have a Mongolian spot in one or more places on the body. The most common locations for Mongolian spots include the buttocks, back, shoulders, or the lower part of the spine. However, in most cases, the Mongolian spot does not cover more than 5% of the body surface.

Characteristics of Mongolian spots include:

• Flat and have the same texture as normal skin
• Blue or blue-gray spots
• 2 to 8 centimeters wide or larger
• Irregular shape and unclear edges
• Usually appear at birth or develop soon after
• Not painful to touch

Diagnosis

In diagnosing Mongolian spot, the doctor will start by conducting an interview with the child's parents or caregivers. The doctor will ask about the symptoms, when the spots appeared, how the spots look, where the spots appear, and ask about the race or ancestry of the baby. Furthermore, the doctor will perform a physical examination by looking directly at the spots that appear and looking for where the spots appear.

Basically, the diagnosis of Mongolian spot can be made based on the interview and physical examination because Mongolian spot has a typical clinical appearance. However, in certain cases, the doctor may perform a Wood's Lamp examination, where the doctor uses a special light to look at the surface of the skin. In addition, the doctor may also suggest a skin biopsy if other skin diseases are suspected. In a skin biopsy, the doctor will take a small sample of skin to be examined in the laboratory.

Management

Mongolian spot is not a dangerous skin condition. Most cases will go away on their own by the time the baby is 3 to 5 years old. However, some cases of Mongolian spot may persist in adulthood. In persistent Mongolian spot cases, management is mostly conservative. Mongolian spots mostly appear in places that can be easily covered with clothing or easily camouflaged with cosmetics.

In addition, there are reports from various studies that the use of lasers can camouflage Mongolian spots. The lasers considered effective for reducing Mongolian spots are Alexandrite, Intense Pulse Dyed (IPL), and Q-switched Nd:YAG. Studies have also shown that the success rate of laser Mongolian spot management is higher if performed before the age of 20 years.

Complications

Basically, Mongolian spot is not a dangerous condition and does not cause complications. As with other birthmarks, Mongolian spots may cause aesthetic and psychological problems, especially if the spots appear on areas of skin that are rarely covered by clothing. In very rare cases, extensive and numerous Mongolian spots may be associated with certain diseases, such as lysosomal storage diseases (especially GM1 gangliosidosis type 1) and blood vessel formation disorders (as in phakomatosis pigmentovascularis).

Prevention

A Mongolian spot is a type of birthmark that has been present since birth. There is no known way to prevent the formation of Mongolian spots in infants, as the cause of Mongolian spot formation is still unclear.

When to See a Doctor?

Mongolian spots are generally harmless birthmarks. However, sometimes some spots or birthmarks can be a sign of a more serious condition. Therefore, it is advisable to consult a doctor if your baby has a spot that occurs at birth to find out the cause. Also, consult a doctor if your baby has spotting that:

Here are signs and symptoms that require further evaluation:

• Increases in width
• Are accompanied by pain
• Have a higher surface than the surrounding skin
• Do not appear blue or discolored

If you experience any of these signs or symptoms, it is important to seek medical attention for further evaluation, an accurate diagnosis, and appropriate management.

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