Introduction to coffee spots

  Coffee spots are persistent hyperpigmented spots with different sizes and clear borders. They are hereditary skin diseases, not related to sun exposure, and can be a sign of multi-system diseases, such as neurofibromatosis, Albright syndrome, Waston syndrome, Russell-Silver dwarfism, multiple nigra syndrome and ataxia capillaris.  Coffee spots are light brown spots, tan to dark brown, varying in size, round, oval or irregular in shape, with clear borders and smooth surface. They can appear at birth or later and increase in number throughout childhood. They are most often found on the trunk and do not fade on their own. It is believed that 90% of patients with neurofibromatosis have café-au-lait spots, and if there are six café-au-lait spots larger than 1.5 cm in diameter, the patient often has neurofibromatosis. Caffeine spots can have different characteristics and be accompanied by other abnormalities in different diseases.   Pathological changes of café-au-lait spots include an increase in epidermal melanin, especially in the basal layer, dope-stained melanocytes and large melanosomes in the keratin-forming cells of the basal layer, and normal or slightly increased melanocytes in the basal layer.  The diagnosis of café-au-lait is based on the age of onset and can be diagnosed by a milk café-au-lait colored patch with clear edges, which should be distinguished from freckles and simple freckle-like nevus. Freckles mainly occur on the face, with small spots and no large patchy damage. Simple freckle-like nevus is mostly divided into unilateral distribution and can occur at any age.

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