Mongolian spots.

Mongolian spots (MS) are birthmarks that are present at birth and their most common location is sacrococcygeal or lumbar area. Lesions may be single or multiple and usually involve < 5% total body surface area. They are macular and round, oval or irregular in shape. The color varies from blue to greenish, gray, black or a combination of any of the above. The size varies from few to more than 20 centimetres. Pigmentation is most intense at the age of one year and gradually fades thereafter. It is rarely seen after the age of 6 years. Aberrant MS over occiput, temple, mandibular area, shoulders and limbs may be confused with other dermal melanocytoses and bruises secondary to child abuse, thus necessitating documentation at birth. Although regarded as benign, recent data suggest that MS may be associated with inborn errors of metabolism and neurocristopathies. Mongolian spots usually resolve by early childhood and hence no treatment is generally needed if they are located in the sacral area. However, sometimes it may be required for extrasacral lesions for cosmesis.

Pigmentary skin disorders in black Africans of Sierra Leon

Eighty percent of the world`s population consists of individuals with pigmented skin. Darker skin differs from Caucasian skin in its reactivity and disease presentation. The purpose of the study was to see the prevalence of disorders of pigmentation in black Africans of eastern province of Sierra Leone and to compare the differences with other ethnic populations. The study was carried out in eastern province [Kenema] of Sierra Leone from Nov, 2004 to Oct, 2005. It was an observational/descriptive study. Local black patients of all age groups presenting in dermatology out patient department of Pak Field Hospital [established as a part of UN peacekeeping mission in Sierra Leone] were included. After clinical history and physical examination, laboratory investigations were carried out when indicated. Skin diseases were broadly classified into two major categories i.e. pigmentary and non pigmentary. Non-black settlers in the area and UN troops were not included in the study. Data was recorded and analyzed by Microsoft Excel. A total of 3011 patients belonging to different local tribes having a variety of skin disorders were seen during the study period. Patients were of all ages and both sexes ranging from I month to 73 years of age. Sex ratio was almost equal. The pigmentary skin disorders were seen in 228 [7.6%] patients and most prevalent disorders were post inflammatory hyper and hypopigmentation, followed by melasma, vitiligo and albinism. Pigmentary disorders in blacks are not infrequent and can be of significant concern