Mongolian spot

Şablon:Infobox medical condition Mongolian spot (congenital dermal melanocytosis) is a benign, flat, congenital birthmark with wavy borders and irregular shape. In 1883 it was described and named after Mongolians by Erwin Bälz, a German anthropologist based in Japan.<ref>Die koerperlichen Eigenschaften der Japaner.(1885) Baelz.E. Mittheil.d.deusch Gesell.f.Natur-u-Voelkerheilkunde Ostasiens. Bd.4.H.32</ref><ref>Circumscribed dermal melanosis (Mongolian spot)(1981) Kikuchi I, Inoue S. in "Biology and Diseases of Dermal Pigmentation", University of Tokyo Press , p83</ref><ref>Şablon:Cite book</ref><ref>Şablon:Cite book</ref> It normally disappears three to five years after birth and almost always by puberty. The most common color is blue, although they can be blue-gray, blue-black or deep brown.

Cause

The Mongolian spot is a congenital developmental condition—that is, one existing from birth—exclusively involving the skin. The blue colour is caused by melanocytes, melanin-containing cells, that are usually located in the surface of the skin (the epidermis), but are in the deeper region (the dermis) in the location of the spot.<ref name=skin /> Usually, as multiple spots or one large patch, it covers one or more of the lumbosacral area (lower back), the buttocks, sides, and shoulders.<ref name=skin /> It results from the entrapment of melanocytes in the lower half to two-thirds of the dermis during their migration from the neural crest to the epidermis during embryonic development.<ref name=skin />

Male and female infants are equally predisposed to Mongolian spot.Şablon:Citation needed

People who are not aware of the background of the Mongolian spots may mistake them for bruises, possibly resulting in unfounded concerns about abuse.<ref>Mongolian Spot - English information of Mongolian spot, written by Hironao NUMABE, M.D., Tokyo Medical University.</ref><ref>Şablon:Cite book</ref><ref>Şablon:Cite book</ref>

Prevalence

Infants may be born with one or more Mongolian spots ranging from small area on the buttocks to a larger area on the back.

The spot is prevalent among East, South, Southeast, North and Central Asian peoples, Uralic and Finno-Ugric peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), Sub-Saharan Africans,<ref>Şablon:Cite book</ref> Amerindians,<ref>Şablon:Cite book</ref> non-European Latin Americans, Caribbeans of mixed-race descent, and Turkish people.<ref name=skin>Mongolian blue spots - Health care guide discussing the Mongolian blue spot.</ref><ref>Şablon:Cite journal</ref><ref name=tokyo>Şablon:Cite web</ref><ref>Transcultural Medicine: Dealing with patients from different cultures</ref> They occur in about 90-95% of Asian and 80-85% Native American infants.<ref name="tokyo"/> Approximately 90% of Polynesians and Micronesians are born with Mongolian spots, as are about 46% of children in Latin America,<ref name=med>Epidemiology of Mongolian spot on MedScape</ref> where they are associated with non-European descent. These spots also appear on 5-10% of babies of full Caucasian descent; Coria del Río in Spain has a high incidence due to the presence of descendants of the first Japanese official envoy to Spain in the early 17th century.<ref name="tokyo"/><ref>Şablon:Cite web</ref> Black babies have Mongolian spots at a frequency of 96%.<ref>Şablon:Cite book</ref>

Almost the entire mestizo (mixed Spanish-Indian) people of Mexico have the Mongolian spot.<ref>Şablon:Cite book</ref>

Central Americans indigenous children were subjected to racism due to their Mongolian spots but progressive circles began to make having the Mongolian spot popular after the late 1960s.<ref>Şablon:Cite book</ref>

Highland Peruvians have the Mongolian spot.<ref>Şablon:Cite book</ref>

Anthropological description

The French anthropologist Robert Gessain interested himself in what he called the tache pigmentaire congenitale or coloured birthmark, publishing multiple papers in the Journal de la Société des Américanistes, an academic journal covering the cultural anthropology of the Americas. Gessain spent time with the Huehuetla Tepehua people in Hidalgo, Mexico, and wrote in 1947 about the spot's "location, shape, colour, histology, chemistry, genetic transmission, and racial distribution". He had previously spent several winters in Greenland, and wrote an overview in 1953 of what was known about the spot. He hypothesised that the age at which it faded in various populations might prove to be a distinguishing characteristic of those groups. Gessain claimed that the spot was first observed amongst the Eskimo.<ref name="auto">Şablon:Cite journal</ref>

Hans Egede Saabye, a Danish priest and botanist, spent 1770-1778 in Greenland. His diaries, published in 1816 and translated into several European languages, contained much ethnographic information. He described the spot on newborns, saying he had seen it often when the infants were presented naked for baptism. A second Danish observer was doctor and zoologist Daniel Frederik Eschricht, mainly based in Copenhagen. In 1849 he wrote of the "mixed" babies he had delivered at the lying-in hospital. He also says that "the observation made for the first time by Saabye about Eskimo children has been completely confirmed by Captain Holbøll", who sent him a fetus pickled in alcohol.<ref name="auto"/>

Gessain goes on to state that it was only in 1883 that an anthropologist mentions the spot. It was Erwin Bälz, a German working in Tokyo, who described a dark blue mark on Japanese infants. He presented his findings in 1901 in Berlin, and from that point on, Bälz's name was associated with certain skin cells containing pigment. Captain Gustav Frederik Holm wrote in 1887 that his Greenlandic interpreter Johannes Hansen (known as Hanserak) attested to the existence of the birthmark over the kidney region of newborns, which grows larger as they grow older. That year, the Danish anthropologist Soren Hansen drew the connection between the observations of Bälz in Japan and Saabye in Greenland. "This cannot be a coincidence. It is not the first time that the resemblance between the Japanese and the Eskimo has been pointed out." Fridtjof Nansen, the Norwegian polar explorer, said that the spot was widespread in the mixed Danish-Eskimo population of West Greenland. Soren Hansen confirmed this, and further hypothesised that in both Japan and Greenland the spot might indicate an African connection ("a sign of direct descent from a black racial element"). (See Historical race concepts.) A missionary in Bethel, Alaska, a traditional gathering place of Yup'ik people, reported that the spots were common on children. Rudolf Trebitsh, an Austrian linguist and ethnologist, spent the summer of 1906 on the West Coast of Greenland, and listed all the examples he came across. Gessain went to north Labrador in 1926, looking for children with these spots. In 1953 Dr Saxtorph, medical advisor to the Greenland department (part of the Danish government), wrote that the Greenlanders do not like outsiders to see or discuss these birthmarks; "they doubtless feel as a reminiscence of the time when they lived on a low cultural level".<ref name="auto"/>

The presence or absence of the Mongolian spot was used by racial theorists such as Joseph Deniker (1852-1918), the French anthropologist.<ref>Şablon:Cite journal</ref>

The Journal of Cutaneous Diseases Including Syphilis, Volume 23 contained several accounts of the Mongolian spot on children in the Americas:

In Central America, according to these authorities, the spot is called Uits, "pan," and it is an insult to speak of it. It disappears in the tenth month. It is bluish-reddish (in these red men), and is remarkable by its littleness. Mayan half-breed infants do not have it (red men and Spanish white). The mulberry colored spot is very well known in Negroid Brazil. Among individuals of mixed Indian blood (black and red) it is called "genipapo" from its resemblance in color (bluish-gray) to an indigenous fruit of Brazil, named genipapo (an Indian word adopted into Portuguese).

Tem genipapo means the same as "he is of colored (negro) race." Brazilians say that the spot has a great tendency to preserve itself through the generations by inheritance, and that "Indian blood" is never lost when entering a new. This is the explanation made by those in whose family it occurs. It is rather like the Minorcan blood of the Dr. Trumbull negroes of St. Augustine, Florida, among whom this same spot shows itself even to-day. Yet no one knows them to be black, except that a dark child is sometimes born and strangled by the beautiful women of that race descended from the old Negress of Spain, whom Dr. Trumbull married and brought to America with him. Dr. Lehmann-Nitsche (Mancha Morada de los recien Nacidos, La Semana Medico, 1904) has known of cases of the spot among very swarthy individuals of Europe. He believes that the religious Brazilians are wrong in their accusation that it is the "Seal of Cain" ("Cain's seal was on the forehead. Besides, a tribal tattooing in all probability was Cain's seal, as every anthropologist might explain").<ref>Şablon:Cite book</ref>

A marriage between a Chinese man and a white Mexican woman was recorded in Current Anthropological Literature, published in 1912, titled "Note on two children born to a Chinese and a Mexican white" (Note sur deux enfants nés d'un chinois et d'une mexicaine de race blanche). "Treats briefly of Chen Tean (of Hong Kong), his wife, Inez Mancha (a white Mexican), married in 1907, and their children, a boy (born April 14, 1908) and a girl (born September 24, 1909). The boy is of marked Chinese type, the girl much more European. No Mongolian spots were noticed at birth. Both children were born with red cheeks. Neither has ever been sick. The boy began to walk at ten months, the girl a little after a year."<ref>Şablon:Cite book</ref>

Cultural terminology

The Mongolian spot is referred to in the Japanese idiom shiri ga aoi (Şablon:Lang), meaning "to have a blue butt",<ref>尻 Şablon:Ja icon</ref><ref>"The butt is blue": the untold story, Language Log, October 15, 2008 @ 3:14 pm; comment of October 16, 2008 @ 11:39 am</ref> which is a reference to immaturity or inexperience. In central Mexico, The expression is used in the same way, being locally referred to as the "green butt" (Şablon:Lang-es). It is also referred to as la patada de Cuauhtémoc, meaning "Cuauhtémoc's kick".Şablon:Citation needed The mark is also common among Maya people of the Yucatan Peninsula <ref>Life Magazine - Ancient and Modern Maya (june 1947) [1]</ref> where is referred to as Wa in Maya, which means "circle". Korean mythology explains the spot as a bruise formed when Samshin halmi (Şablon:Lang-ko), a shaman spirit to whom people pray around childbirth, slapped the baby's behind to hasten the baby to quickly get out from his or her mother's womb.

In Ecuador, the native Indians of Colta are insultingly referred to in Spanish by a number of terms which allude to the Mongolian spot.<ref>Şablon:Cite book</ref>

In Spanish it is called mancha mongólica and mancha de Baelz (see Erwin Bälz).<ref>Şablon:Cite book</ref>

See also

• List of cutaneous conditions