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Cafe-Au-Lait Macule
Aka: Cafe-Au-Lait Macule, Cafe-Au-Lait Spot, Cafe Au Lait
- Pathophysiology
- Congenital or develops in early childhood
- Hyperpigmentation from increased Melanin deposition
- Epidemiology
- Often present at birth
- Isolated lesions are common (present in up to 10-30% of the population)
- Symptoms
- Asymptomatic
- 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
- 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
- Associated Conditions (if >6 lesions)
- Neurofibromatosis
- Tuberous Sclerosis
- Albright Syndrome
- Fanconi Anemia
- Management
- None needed
- Consider treatment only for cosmetic reasons
- Laser therapy
- Surgical excision
- References
- Plensdorf (2017) Am Fam Physician 96(12): 797-804 [PubMed]
- Plensdorf (2009) Am Fam Physician 79(2): 109-16 [PubMed]