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A Newborn with "Black Spots".

A newborn presents with “black spots” all over the body.

### Prenatal and Birth Histories

### Presentation

The infant was admitted to the NICU for evaluation of possible infection because of suspected maternal chorioamnionitis. On physical examination, the infant was active. The infant had more than 20 brown and black macules and patches on the trunk and the lower extremities (Figs 1 and 2). An 11-cm sharply circumscribed brownish black plaque with verrucous texture and no visible hair follicles was noted and involved the entire left side of the scalp, sparing the occipital region (Fig 3).



Figure 1. 
Multiple hyperpigmented lesions on the back.





Figure 2. 
Multiple hyperpigmented lesions on the lateral of thigh.





Figure 3. 
A large brownish black plaque on the scalp.



The mother’s medical history was significant for 20 nonmalignant black macules and patches on her back, mainly in the interscapular region. The infant’s maternal grandmother reported similar skin lesions over her body, with dense distribution on the lower extremities.

### Vital Signs