Mongolian Spots: Two Views

Mongolian spots are benign, congenital blue-gray macules or patches commonly found in Asian, black, and Hispanic infants (and in 5% of white infants). They are most often located in the sacrogluteal area and the upper back. The lesions may be solitary or multiple, vary in color intensity, and frequently enlarge until about age 2, when they gradually fade and disappear. Approximately 5% persist into adulthood.

Drs Charles E. Crutchfield III, Eric B. Richardson, and Eric J. Lewis of Minneapolis, who noted the bruiselike lesions on an 11-month-old Asian infant during a routine visit, warn against mistaking mongolian spots for signs of physical abuse.

Drs Leslie Trope, Eric Capulla, and Hillel Trope of New York found a large pigmented area on the lower back and buttocks of a 28-year-old black man. There is also excessive hair growth in the pigmented area, although the patient's torso is otherwise predominantly hairless. The differential diagnosis rests between mongolian spots and an extensive hairy nevus. Because of the distribution of this pigmentation and the fact that the patient said it had been present since birth, the diagnosis of mongolian spots was made.