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Newborn with ear and skin anomalies at birth
  1. Steven Montgomery1,
  2. Phillip Ross1,
  3. Art O’Hagan2,
  4. Keith Trimble3,
  5. Shilpa Shah1
  1. 1 Paediatrics, Southern Health and Social Care Trust, Portadown, UK
  2. 2 Dermatology, Southern Health and Social Care Trust, Portadown, UK
  3. 3 Ear, Nose, Throat Department, Belfast Health and Social Care Trust, Belfast, UK
  1. Correspondence to Dr Shilpa Shah, Paediatrics, Southern Health and Social Care Trust, Portadown BT635QQ, UK; drshilparshah{at}

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History and examination

A term, appropriately grown, female infant born in good condition by vaginal delivery with normal antenatal course was noted to have an abnormality of the right external ear (figure 1) and two birthmarks (figures 2 and 3) that did not grow in size at follow-up aged 3 months.

Figure 1

Showing right ear.

Figure 2

Showing chest skin lesion.

Figure 3

Showing forearm lesion.

Test your knowledge

  1. What is the likely cause of these birth defects?

    1. Chromosomal abnormality

    2. Single gene mutation

    3. Prenatal environment

    4. Multifactorial influences

    5. Unknown

  2. What are the vascular lesions?

    1. Superficial infantile haemangioma (IH)

    2. PHACE syndrome

    3. Kasabach-Merritt phenomenon

    4. Port-wine stain

    5. Naevus simplex

  3. With regard to the ear anomaly, what are the immediate next steps?

    1. Referral to clinicians with knowledge of microtia

    2. Behaviour audiometry and ear-specific hearing information

    3. Bone-anchored hearing aid

    4. CT imaging for external auditory canal and corrective surgery

    5. Referral …

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  • 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; internally peer reviewed.