Port wine stainThis reddish-purple birthmark is a major cosmetic blemish which can occur anywhere on the body. It is caused by an increased number of blood vessels under the skin’s surface, and becomes darker and more lumpy with time.Today, laser treatment of birthmarks is common. Previously, lasers such as the argon were used, but these caused several problems, especially scarring. Copper vapour lasers and pulsed dye lasers are now used to treat wine stains. This should be done early in life as the results are superior. In addition, major psychological problems can be avoided.
Strawberry birthmarksThese dark red, strawberry-like growths usually appear in the first few weeks of life, enlarge rapidly, and may bleed. They may cause major cosmetic disfigurement and can even obstruct vital organs such as the eyes. Because most strawberry birthmarks resolve by the age of seven, they largely go untreated unless there is some obstruction to breathing or to the vision. Older treatments such as radiation therapy were abandoned as they caused scarring. Nowadays, with sophisticated lasers such as the pulsed dye, the copper vapour and the Nd-Yag available, these marks can be successfully treated. This is best done early in childhood.
Pale brown birthmarksPale brown birthmarks are often due to an accumulation of pigment but do not have an increased risk of malignant melanoma (potentially deadly tumour). They occur at birth or appear soon after and are not generally very visible. These birthmarks often become more noticeable during summer as they grow darker following sun exposure. During winter they grow paler. They do not usually require treatment although some people have them removed for cosmetic reasons.
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The B.C.C. is a tumour arising from the cells of the basal layer of the epidermis. The abnormal cells leave their normal position and invade the dermis. It is a relatively innocent cancer, as it does not usually invade blood vessels and spread to distant sites. If left untreated, however, it will quietly spread to the surrounding skin and erode underlying tissues, such as bone. Hence, in the past, these cancers have been called ‘rodent ulcers’.

Causes. Unlike most S.C.Cs, B.C.C.s are not usually preceded by an obvious pre-malignant lesion. Although prolonged sunlight exposure is an important factor in their causation, other factors must be involved also. B.C.C.s are much more common in sunny climates and in light-skinned individuals, and two-thirds occur on the head and neck. However, one-third occur in relatively protected sites, such as on the body, eyelids, and behind the ears. It is therefore thought that regional factors must also be involved.

Features. Patients often describe how they have noticed a spot which, although it is not troubling them, does not go away; it may bleed or crust over, but will never quite heal. The appearances are varied. Most typically, it is a small pearl-like nodule with fine blood vessels overlying it. Sometimes it looks like a very small erosion of the skin, or an ulcer. Overlying it. there may be a small crust. Occasionally it appears like a red scaly plaque with o scalloped margin.

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