*4.4.2. Mongolian spots (Africans, Americans, Asians)*

Mongolian Spots, also known as Mongolian Blue Spots or congenital dermal melanocytosis, represent a congenital condition characterized by the presence of smooth spots, irregularshaped with wavy borders, dark blue to brown, with a normal skin texture [48]. They may be present from birth or may appear within the first few weeks of life during the neonatal period.

**Figure 9.** Capilary hemangioma – Forearm.

Mongoloid Spots represent an agglomeration of dermal melanocytes and is not a clinical sign associated with a disease or syndrome.

*4.4.3. Cutis marmorata telangiectatica congenita*

but they are not reported [54].

*4.4.4. Pigmentary nevi*

6 mm in diameter [57, 58].

vessels, and it occurs most frequently in the hands and feet.

Cutis marmorata telangiectatica congenita is a rare congenital vascular disorder that manifests itself by affecting the blood vessels of the skin by alternating a vascular network with a vasodilation and vasoconstriction process which gives the skin a marbled appearance. It is accentuated by cold temperatures, but it does not disappear when exposed to warmer temperatures [52].

The Neonate with Minor Dysmorphisms http://dx.doi.org/10.5772/intechopen.71902 521

It should not be confused with Cutis Marmorata, which is a normal, adaptive, physiological response of the newborn to exposure to low temperatures. This disorder is due to a neurological and vascular immature system, it varies between the constriction and dilation of blood

Very few cases of cutis marmorata telangiectatica congenita have been reported worldwide less than 100 cases [53], but in reality it is more common than that. Mild forms are not that rare,

**The pathophysiological mechanisms** are still unclear, with most cases occurring sporadically, although rare cases were reported in some families. Studies indicate the primary involvement

The hypothetical mechanisms that have been proposed are environmental factors, peripheral neural dysfunctions, failure of the development of mesodermic vessels in an early embryonic

**Diagnosis**: skin manifestations may be associated with the asymmetry of extremities, macrocephaly, glaucoma, cutaneous atrophy, chronic skin ulcerations, neurological anomalies, vascular anomalies (nevus flammeus, Sturge–Weber syndrome, Klippel-Trénauna syndrome,

**Management**: in general, there is no treatment for this condition, but the associated anomalies can be treated. In the case of limb asymmetry, without motor dysfunction, there is the possibility of inserting an "elevation" device for the shorter leg during early childhood. Laser therapy has not been successful in the treatment of this vascular skin disorder, possibly due

**Prognosis**: the prognosis is favorable in most cases, when patients experience an isolated cutaneous abnormality. In most cases, the marbled appearance regresses spontaneously during the first year of life due to the normal maturation process, with the thickening of the epidermis and dermis. In fewer cases, lesions can continue for up to 10 years or throughout the patient's life.

Pigmentary nevi, also known as melanocytic nevi, are benign neoplasms present from birth -

Pigmentary nevi appear with a high frequency as uniform, beige, brown or skin-color formations, sometimes protruding, circular or oval, with regular, smooth, well-defined margins, of

of capillaries, venules and veins, and possibly arterioles and lymphatic vessels.

stage and autosomal dominant inheritance with incomplete penetrance [52, 55].

Adams Oliver syndrome), psychomotor and /or mental retardation [56].

to many dilated capillaries and veins in the deep layers of the skin.

congenital melanocytic nevi may develop throughout life.

Depending on the location of melanocytes on the surface of the skin, the coloration of the Mongoloid Spots change. If they are superficially located, the color of the spots is brown, and the deeper they are, the color tends more and more to have a blue shade [48, 49].

Mongoloid Spots are most commonly diagnosed at birth due to specific coloration and localization, and no additional investigation methods are required. They are found with a frequency of 90% in the black population and the Native Americans, in about 80% of Asian infants, 70% of Hispanic individuals and in a reduced proportion of 5–10% of Caucasian children [48, 49]. Incidence is lower in preterm infants compared to full-term infants, and in terms of gender distribution, the incidence is higher in boys.

Most spots are located on the buttocks, lumbosacral (**Figure 10**), deltoid and dorsal region, on the limbs and in rare cases on the face or on the occipital region. There may be single or multiple spots, ranging in size from 1 to 2 cm to tens of cm [50].
