Nevus Simplex Or A Salmon Patch - A Vascular Lesion Of Infancy

Nevus simplex (salmon patch) is the most common vascular lesion in infancy, present in about 40% to 60% of newborns. It appears as a blanching, slightly pink-red macule or patch 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 but may become more prominent with crying or straining.

                                 Newborn with characteristic salmon patches over his face.

Important Points:
1. Salmon patches are composed of ectatic dermal capillaries.
2. Salmon patches appear symmetrically and cross the midline in contrast to the unilateral distribution of a port-wine stain.
3. When seen on the nape of the neck, this lesion is referred to as a stork bite  (see picture below) or as an angel’s kiss when appearing on the forehead.

4. About 5% of those appearing at the nape of the neck will remain permanently or recur.

                Characteristic lesion on the nape of the neck is commonly called a stork bite

5. 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).

Management: 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.