Nevus simplex (salmon patch) is the most common vascular lesion in infancy, present in up to 80% of newborns. They are ectatic dermal capillaries that appear as a blanching, slightly pink-red macule or patch with indistinct borders 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 and may become more prominent with crying or straining.
Management and Disposition
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.
Salmon patches appear symmetrically and cross the midline in contrast to the unilateral distribution of a port-wine stain.
This lesion is referred to as a stork bite when seen on the nape of the neck or as an angel’s kiss when appearing on the forehead.
About 5% of those appearing at the nape of the neck will persist or recur.
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).
Salmon Patches. Newborn with characteristic salmon patches over his face. (Photo contributor: Anne W. Lucky, MD.)
Salmon Patches. Child with patch over lower back consistent with salmon patches. (Photo contributor: Anne W. Lucky, MD.)
Salmon Patches. Characteristic lesion on the nape of the neck is commonly called a stork bite. (Photo contributors: Katharine Hanlon and Kara Shah, MD, PhD.)