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Large skin lesion at birth
  1. Shahd Elamin1,
  2. Ben Rafferty2,
  3. Susannah Hoey1
  1. 1 Dermatology, Royal Victoria Hospital, Belfast, UK
  2. 2 Neonatal Intensive Care Unit, Royal Jubilee Maternity Service, Belfast, UK
  1. Correspondence to Dr Shahd Elamin, Dermatology, Royal Victoria Hospital, Belfast, UK; selamin01{at}

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Case presentation

A large pigmented lesion was noted across the back on a baby boy at birth. He was born to non-consanguineous parents and by an uncomplicated vaginal delivery at 38+1 weeks. He weighed 2.62 kg. There is no family history of similar skin conditions.

On examination, there was a large, asymmetrical, heterogeneously pigmented lesion covering most of his back, extending to the buttocks (figure 1). The margins were irregular and did not contain any hair. It measured 21 cm. There were smaller lesions on his face, scalp and lower limbs (figure 2). No other congenital abnormalities were noted. Postnatal baby check including neurological examination was normal.

Figure 1

Distribution of lesions on back

Figure 2

Smaller lesion on leg.

Test your knowledge

  1. What is the most likely diagnosis?

    1. Large congenital melanocytic naevus.

    2. Plexiform neurofibroma.

    3. Becker’s melanosis.

    4. Smooth muscle hamartoma.

  2. Which complication of this condition is the patient at most risk …

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  • Contributors SE and BR drafted the initial manuscript. SH critically reviewed the final manuscript prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.