Pediatric emergency medicine trisk 1348 1348
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FIGURE 69.17 Dark blue patches on the buttocks and back of infant with dermal
melanocytosis, formerly called Mongolian spots.
Additionally, certain syndromes such neurofibromatosis, are associated with
early-onset pigmented skin lesions. Patients with this disease can initially present
with café-au-lait spots, which are flat, nonpalpable, coffee-colored lesions of
varying size and shape. When six or more lesions are present, greater than 0.5 cm
in size, neurofibromatosis should be considered. The Peutz–Jeghers syndrome is a
dominantly inherited condition that includes freckle-like lesions of the lips, nose,
buccal mucosa, fingertips, and subungual areas associated with polyps in the
small intestine, stomach, or colon. Melena and intussusception are the chief
complications that may develop, usually in the second decade of life. McCune–
