Can you identify this birthmark?

The mother of a 6-month-old girl was alarmed by the birthmark on her daughter’s lower back. The child is otherwise healthy.

Can you identify this lesion?

A. Strawberry hemangioma.

B. Cherry angioma.

C. Salmon patch.

D. Port-wine stain.

E. Nevus spilus.

ANSWER—Case 1: Port-wine stain

A port-wine stain, D, or nevus flammeus, over the infant’s lower back is a marker for spinal dysraphism, such as spina bifida occulta. These nevi have been associated with neurologic abnormalities secondary to malformations, including vascular malformations of the spine—as seen in Cobb syndrome—and tethering of the spinal cord.

Strawberry hemangiomas and cherry angiomas are raised lesions. Salmon patches are commonly found on the nape of the neck. Nevus spilus is a pigmented lesion.

Radiographs of this child’s spine revealed no abnormality; no treatment was necessary. Removal of port-wine stains is for cosmetic reasons alone.