Normal Color Variations in Children of Color

  • Nanette B. Silverberg


Pigmentation is present in the skin, hair, nails, and mucosal surfaces in all individuals; however, variation exists in the pigmentary distribution and the prominence in pigmentation by location. Such variations are more notable in children of color due to the prominence in pigmentation. This chapter reviews the subtle differences in pigmentation noted in children of color most of which occur in the first 2 years of life. These differences in color may be based on the pattern of pigmentary and embryological development or due to environmental factors such as trauma.


Pigmentation Mucosal surfaces Embryological development Trauma 


  1. 1.
    Andreassi L, Casini L, Simoni S, Bartalini P, Fimiani M. Measurement of cutaneous colour and assessment of skin type. Photodermatol Photoimmunol Photomed. 1990;7:20–4.PubMedGoogle Scholar
  2. 2.
  3. 3.
    Kelly AP. Chapter 13: Nuances in skin of color. In: Kelly AP, Taylor SC, editors. Dermatology for skin of color. New York: McGraw Hill; 2009. p. 81–2.Google Scholar
  4. 4.
    NANDA A, Kaur S, Bhakoo ON, Dhall K. Survey of cutaneous lesions in Indian newborns. Pediatr Dermatol. 1989;6:39–42.CrossRefPubMedGoogle Scholar
  5. 5.
    Cordova A. The Mongolian spot: a study of ethnic differences and a literature review. Clin Pediatr (Phila). 1981;20:714–9.CrossRefGoogle Scholar
  6. 6.
    Monteagudo B, Labandeira J, León-Muiños E, Carballeira I, Corrales A, Cabanillas M, Suárez-Amor O, Toribio J. Prevalence of birthmarks and transient skin lesions in 1,000 Spanish newborns. Actas Dermosifiliogr. 2011;102:264–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Rybojad M, Moraillon I, Ogier de Baulny H, Prigent F, Morel P. Extensive Mongolian spot related to Hurler disease. Ann Dermatol Venereol. 1999;126:35–7.PubMedGoogle Scholar
  8. 8.
    Ochiai T, Ito K, Okada T, Chin M, Shichino H, Mugishima H. Significance of extensive Mongolian spots in Hunter’s syndrome. Br J Dermatol. 2003;148:1173–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Takahasi M. Studies on café au lait spots in neurofibromatosis and pigmented macules of nevus spilus. Tohoku J Exp Med. 1976;118:255–73.CrossRefPubMedGoogle Scholar
  10. 10.
    Whitehouse D. Diagnostic value of the café-au-lait spot in children. Arch Dis Child. 1966;41:316–9.CrossRefPubMedCentralPubMedGoogle Scholar
  11. 11.
    Nunley KS, Gao F, Albers AC, Bayliss SJ, Gutmann DH. Predictive value of café au lait macules at initial consultation in the diagnosis of neurofibromatosis type 1. Arch Dermatol. 2009;145:883–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Dhar S, Kanwar AJ, Kaur S. Nevus depigmentosus in India: experience with 50 patients. Pediatr Dermatol. 1993;10:299–300.CrossRefPubMedGoogle Scholar
  13. 13.
    Fukai K, Ishii M, Kadoya A, Hamada T, Wakamatsu K, Ito S. Nevus depigmentosus systematicus with partial yellow scalp hair due to selective suppression of eumelanogenesis. Pediatr Dermatol. 1993;10:205–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Sciallis GF, Sciallis AP. Becker nevus with an underlying desmoid tumor: a case report and review including Mayo Clinic’s experience. Arch Dermatol. 2010;146:1408–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Happle R. The group of epidermal nevus syndromes Part I. Well defined phenotypes. J Am Acad Dermatol. 2010;63:1–22.CrossRefPubMedGoogle Scholar
  16. 16.
    Mukamal LV, Ormiga P, Ramos-E-Silva M. Dermoscopy of the pigmented fungiform papillae of the tongue. J Dermatol. 2012;39(4):397–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Sergay A, Silverberg NB. Divided café-au-lait macule of the mouth. J Am Acad Dermatol. 2007;56:S98–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Rangwala S, Doherty CB, Katta R. Laugier-Hunziker syndrome: a case report and review of the literature. Dermatol Online J. 2010;16:9.PubMedGoogle Scholar
  19. 19.
    Romiti R, Molina De Medeiros L. Pigmented fungiform papillae of the tongue. Pediatr Dermatol. 2010;27(4):398–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Pehoushek JF, Norton SA, Bliss RW. Black taste buds. Arch Dermatol. 1999;135(594–595):597–8.Google Scholar
  21. 21.
    Hernández-Martín A, Gilliam AE, Baselga E, Vicente A, Lam J, González-Enseñat M, Azorín D, Torrelo A. Hyperpigmented macules on the face of young children: a series of 25 cases. J Am Acad Dermatol. 2014;70:288–90.CrossRefPubMedGoogle Scholar
  22. 22.
    Quatresooz P, Hermanns JF, Hermanns-Le T, Pierard GE, Nizet JL. Laddering melanotic pattern of Langer’s lines in skin of colour. Eur J Dermatol. 2008;18:575–8.PubMedGoogle Scholar
  23. 23.
    James WD, Carter JM, Rodman OG. Pigmentary demarcation lines: a population survey. J Am Acad Dermatol. 1987;16:584–90.CrossRefPubMedGoogle Scholar
  24. 24.
    George AO, Shittu OB, Enwerem E, Wachtel M, Kuti O. The incidence of lower mid-trunk hyperpigmentation (linea nigra) is affected by sex hormone levels. J Natl Med Assoc. 2005;97:685–8.PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of DermatologyMt. Sinai St. Luke’s-Roosevelt Hospital CenterNew YorkUSA
  2. 2.Mt. Sinai Beth Israel Medical CenterNew YorkUSA

Personalised recommendations