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Pigmented lesions of the skin-2

Author: akanksha, Posted on Thursday, April 19 @ 16:05:51 IST by akanksha  

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AIIMS

    A 3-month-old baby is brought in by concerned parents who have noticed that a red lesion over his forehead, present from birth, has begun to reduce in size but has developed a black area centrally. There is no other lymphadenopathy and the child is otherwise developing normally. Most probable diagnosis is:
    a. Blue naevus
    b. Campbell de Morgan spot
    c. Strawberry naevus
    d. Deep capillary naevus


Correct answer: C. Strawberry naevus
    These lesions appear shortly after birth and tend to occur around the head, neck and napkin area.
    The lesion can grow rapidly to produce a domeshaped, red-purple extrusion which can be friable.
    Despite being unsightly, they usually undergo spontaneous resolution, beginning with an alarminglooking area of central necrosis. Generally, 50% regress by the age of 5 years and 70% by the age of 7 years. Therefore management is expectant but there are specific indications for surgery such as breathing/feeding difficulties or haemorrhage.
    Medical treatment is high-dose prednisolone but in more severe cases, complex surgical intervention may be required.



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