II. Pathophysiology
- Congenital or develops in early childhood
- Hyperpigmentation from increased Melanin deposition
III. Epidemiology
- Often present at birth
- Isolated lesions are common (present in up to 10-30% of the population)
IV. Symptoms
- Asymptomatic
V. Signs
- "Coffee with milk" (tan to brown) colored flat Macule
- Usually located on trunk
- Size varies from <4 cm in infants to 20-30 cm in adults
VI. Red Flags: Criteria to consider associated congenital conditions below
- Six or more lesions that meet size criteria
- Size criteria
- Prepubertal: Lesions 5 mm or larger
- Postpubertal: Lesions 15 mm or larger
VII. Associated Conditions (if >6 lesions)
- Neurofibromatosis
- Tuberous Sclerosis
- Albright Syndrome
- Fanconi Anemia
VIII. Management
- None needed
- Consider treatment only for cosmetic reasons
- Laser therapy
- Surgical excision