Salmon Patch
Naevus Simplex, Erythema Nuchae, Unna's Naevus, "Stork Bite", "Angel's Kiss"
This lesion highlights the difficulty of categorising dermal arteriovenous malformations. The macular area, irregular border and coloration suggest that the lesion is a salmon patch. However, the site is not typical and linear telangiectasia are not easily observed.
The roughly trigeminal distribution of this lesion may suggest the diagnosis of portwine stain, but the colour and irregular dull border favour the diagnosis of a Salmon patch.
Features
Salmon patches are composed of distended and persisting fetal dermal capillaries. Clinically they appear as irregular dull, pinkish red, macular areas, often featuring fine, linear telangiectasia. The most common site of the lesion is the nape of the neck. Other commonly affected sites include upper eyelids, forehead and tip of the nose. They become more noticeable when the child cries or otherwise exerts itself. Lesions are often present at more than one site.
Most salmon patches fade after the first month of life, but the lesions on the nape of the neck sometimes persist longer than this, with some 50% of nuchal lesions persisting into adult life.
Incidence
Salmon patches have been observed in 20-60% of all newborns. Previous studies have suggested a higher incidence in Caucasians, but it is now thought that this may be due to the lesions being more easily identified on lighter skin.
Aetiology
A localised capillary telangiectatic lesion of unknown aetiology.
Differential Diagnosis
Treatment
None required. If the lesion persists and the patient wishes to have it removed, laser therapy may be considered.
