It is important to differentiate between the three most common
vascular anomalies in newborns: capillary stains that self-resolve,
port-wine stains that benefit from laser treatment, and hemangiomas,
which spontaneously involute.
The salmon patch is the most common benign vascular lesion seen
in infants, typically on the forehead, glabella, or nape of neck
that are most prominent during infancy, then self-resolve during
Synonyms Nevus simplex, telangiectatic
nevus, “stork bite,” nuchal nevus, Unna’s
nevus, evanescent macule, angel kiss, or aigrette.
Age Present at birth, fades with
Incidence Occurs in 30% to
40% of newborns.
Etiology Thought to be a persistence
of fetal circulation, gradually becomes less prominent.
Present at birth, these benign lesions fade with time. In lighter
skin types, the patch may be more persistent or evident during episodes
of crying or physical exertion. Fifty percent of salmon patches
in the nuchal region persist for life. They are asymptomatic and
Type Macular with telangiectasias.
Distribution Head and neck.
Sites of Predilection Nape of neck
(22%), glabella (20%) (Fig. 8-1A), and eyelids
Salmon patch A. Salmon
patch on the glabella of a newborn. B. Same
child at age 3 with no residual vascular lesion.
Salmon patch is the most common vascular birthmark. Its classic
locations and self-resolving tendencies should differentiate it
from other vascular birthmarks such as capillary malformations and hemangiomas.
Histopathology Skin biopsy reveals
dilated dermal capillaries.
Facial salmon patches fade with time (Fig. 8-1B) and only become
evident in lighter skin types with crying or physical exertion.
Nuchal salmon patches can persist but are asymptomatic and not usually
of cosmetic concern because they are covered by the posterior hairline.
Unlike capillary malformations, facial salmon patches fade almost
completely and usually do not require treatment. Persistent lesions
can occur in the nuchal area, but these are typically covered with
hair and not a cosmetic concern. Rare bothersome persistent lesions
can be treated with laser ablation.
(Port-Wine Stain) and Associated Syndromes
The most common capillary malformation is a port-wine stain (PWS):
a lesion comprising dilated capillaries, which are macular ...