Pediatric emergency medicine trisk 2483 2483
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secondary infection. Kasabach–Merritt syndrome, which presents as large,
rapidly enlarging hemangiomas associated with thrombocytopenia and
consumption coagulopathy, should be referred to appropriate specialists for
management. Monitor serial CBC and if evidence of significant
bleeding/coagulopathy, may require transfusions of red cells, platelets, or
coagulation factors.
Pigment Changes
Mongolian spots are poorly circumscribed lesions of bluish-gray maculae
generally located over the lumbosacral region, buttocks, and lower limb.
Mongolian spots are more commonly noted in infants of African-American,
Native American, Hispanic, and East Asian descent. Lesions usually fade during
the first year of life and do not require intervention ( Fig. 96.12 ).
Café-au-lait macules are round or oval, brown macular lesions varying in size
from less than 1 cm to greater than 20 cm. Though small, infrequent café-au-lait
macules are common in the general population, increases in number or size may
be a sign of neurocutaneous disease, such as neurofibromatosis. The clinician
should carefully examine these infants for other cutaneous or systemic signs of
disease ( Fig. 96.13 ).
