Publish date: Posted on
Last updated: May 16, 2022
Keywords #
nevus simplex
NS
stork bite
angel kiss
salmon patch
Diagnosis #
Nevus simplex is a common, benign vascular birthmark. It presents at birth as one or multiple well-demarcated pink/red patches due to dilated vessels within the papillary dermis[1]. The most commonly affected sites include the face, nape of the neck, glabella, and eyelids, but other areas of the body can also be involved. These cutaneous lesions are asymptomatic and the majority resolve by 18 months of age, however some may take several years to fade during childhood; and some may persist into adulthood.[1]
Key Concepts #
- Flat, pink or salmon-colored vascular malformations
- Often symmetric and bilateral
- Blanch with pressure
- Not painful or itchy
- Can become more prominent with crying, breath holding, and vigorous activity [2]
Epidemiology #
NS is the most common congenital vascular lesion, seen in up to 40% of newborns[4]. All races can be affected; however, it is found most often in Caucasians with male and female infants affected equally [3].
Clinical Features #
- Salmon colored patch or multiple patches seen on the face, nape of the neck (“stork bite”), or eyelids (“angel kiss”). Usually symmetric and located at midline.
- Involvement of the lumbosacral spine may indicate underlying spinal dysraphism [4].
- Large and persistent stains may be associated with Beckwith-Wiedemann or Macrocephaly-CM syndrome [4].
- Asymptomaticand self-limiting.
Differential Diagnoses #
Diagnostic Workup #
NS is a clinical diagnosis. In certain cases when the lumbosacral spine is affected, duplex ultrasound or MRI may be performed to screen for spinal dyscrasias [4].
Treatment #
No treatment is warranted the majority of the time. In cosmetically sensitive areas or with persistent stains, pulsed dye laser can be performed to lighten the appearance [4].
References #
- McLaughlin, Maura R et al. “Newborn skin: Part II. Birthmarks.”American family physicianvol. 77,1 (2008): 56-60.
- Cohen, B A. “Hemangiomas in infancy and childhood.”Pediatric annalsvol. 16,1 (1987): 17-26.
- Kanada, Kimberly Natee, BA, et al. “A Prospective Study of Cutaneous Findings in Newborns in the United States: Correlation with Race, Ethnicity, and Gestational Status Using Updated Classification and Nomenclature.” The Journal of Pediatrics, vol. 161, no. 2, 2012, pp. 240–245.
- Maguiness, Sheilagh M, and Marilyn G Liang. “Management of capillary malformations.”Clinics in plastic surgeryvol. 38,1 (2011): 65-73.
