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10 month old infant with 'bruises' on lower back and buttocks
First time parents very concerned about slate-blue-grey bruise-like patches on the backside of their infant.

What is your diagnosis? 

Diagnosis:
Mongolian Spot(s) (patch)
48 year old woman with circular rash on the back of her hands

10 month old infant with 'bruises' on lower back and buttocks


Mongolian Spot
This is an interesting slate-blue macule or patch usually seen on the lower back of children. Technically, it should be termed mongolian patch. Although peculiar in name, this really represents an arrest of migration of melanocytes during embryologic development. It looks blue gray due to the Tindall effect. The vast majority of these lesions will disappear by adolescence, but approximately 10% will persist throughout life. This is usually seen only in a firstborn child and when parents are living in an area without grandparents, the reasoning being it is so common that usually by the second or third child, the parents are fully aware of the condition or the grandparents will let them know it is harmless. I have on rare occasion been asked to do a consult for child abuse, where it was thought that these were bruises in the children, so be aware of this. Once again, it is completely harmless condition that will fade with time.

Charles E. Crutchfield III, MD
Clinical Adjunct Associate Professor of Dermatology
At the
University of Minnesota Medical School
Medical Director, Crutchfield Dermatology
www.CrutchfieldDermatology.com


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