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Nevus simplex (salmon patch) is the most common vascular lesion in infancy, present in up to 80% of newborns. They are ectatic dermal capillaries that appear as a blanching, slightly pink-red macule or patch with indistinct borders most commonly on the nape of the neck, the glabella, mid-forehead, or upper eyelids. Lesions generally fade over the first 2 years of life and may become more prominent with crying or straining.
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Management and Disposition
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Parental education and reassurance can be helpful, but no immediate treatment is indicated. Pulsed dye laser may be considered for persistent lesions that are cosmetically undesirable.
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Salmon patches appear symmetrically and cross the midline in contrast to the unilateral distribution of a port-wine stain.
This lesion is referred to as a stork bite when seen on the nape of the neck or as an angel’s kiss when appearing on the forehead.
About 5% of those appearing at the nape of the neck will persist or recur.
Obtain imaging to evaluate for spinal dysraphism in patients with a lumbosacral nevus simplex and another lumbosacral abnormality (dermal sinus or pit, patch of hypertrichosis, or deviated gluteal cleft).
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