Cafe-Au-Lait Spots, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Cafe-Au-Lait Spots, Diagnosis and Treatment and Related Diseases
Cafe-au-lait spot is a flat, pigmented birthmark often manifesting as a hyper-pigmented skin patch with a sharp border and diameter of > 0.5 cm.
It is also known as circumscribed cafe-au-lait hyper-melanosis, von Recklinghausen spot, or abbreviated as "CALM".
The name cafe au lait is French for "coffee with milk" and refers to their light-brown color.
They are produced by a collection of pigment-forming melanocytes in the epidermis of the skin.
These spots are typically permanent, and may grow or increase in number over time.
Cafe au lait spots are often benign, not harmful but may be linked with syndromes such as neurofibromatosis type 1 and McCune–Albright syndrome.
Cafe-au-lait spots are normally evident at birth (congenital) or occur in early infancy.
They occasionally become apparent later in infancy, particularly after exposure to the sun, which darkens the color.
They may be isolated or linked with systemic diseases such as neurofibromatosis (NF), McCune Albright syndrome, Legius syndrome, and LEOPARD syndrome.

Causes:
The brown color of a cafe-au-lait spot is because of a pigment called melanin, produced in the skin by cells called melanocytes.
Multiple cafe-au-lait spots are related to several genetic syndromes.
Neurofibromatosis type 1 &2
Legius syndrome
McCune Albright syndrome,
LEOPARD syndrome.

Symptoms:
Cafe-au-lait spots:
1.They are light brown in color.
2.The pigment is evenly distributed.
3.They are well demarcated with smooth or irregular border
4.Their shape is often round or oval
Diagnosis
Cafe-au-lait spots are diagnosed visually with measurement of spot size
If significant in number and size, a complete medical examination should be done to find out whether a related syndrome may be present.
Syndromes may be diagnosed from their medical manifestations or by genetic testing

6 or more cafe au lait spots greater than 5 mm in diameter before puberty is a diagnostic feature of neurofibromatosis type I
Skin biopsy may be required for certain syndromes.

Treatment

No medical care is required to treat cafe-au-lait spots.
Cafe au lait spots can be removed with lasers.
Results are inconsistent as the spots are often not entirely removed or can recur after treatment.
Often, a test spot is treated first to help predict the likelihood of treatment success.
Lasers reported to have successfully faded cafe-au-lait spots are:

1.Pulsed-dye laser
2.Er:YAG laser
3.Q-switched Nd:YAG laser
4.Q-switched ruby or alexandrite laser

Results are not consistent.

A study has found lesions with an irregular margin react better than those with a smooth, well-defined border.

Risks for laser surgery are:

1.Transient or permanent hyper-pigmentation,
2.Hypo-pigmentation, and
3.Scarring.
4.Permanent hyper-pigmentation, and
5.Recurrence

Complete disappearance of cafe au liat spots was documented using a pulsed dye laser for 4-14 treatments, with no repeat occurrences at 12 months follow-up
Chinese patients were treated with the Q-switched alexandrite laser and 51.4% patients had good-to-excellent reactions after an average of 3.2 treatments with a low rate of recurrence (10.4%).
The results are normally preferred, and when considerable clearing is obtained, the repeat occurrence rate is low; where clearance is partial, repeat occurrence is as high as 50%.
The risk of post-inflammatory hyper-pigmentation is as high as 50% per treatment.
When this develops, it is essential to wait until it clears before resuming laser treatment.

Treatment of underlying syndromes may be complicated and need multidisciplinary care

TABLE OF CONTENT
Introduction
Chapter 1 Cafe-Au-Lait Spots
Chapter 2 Causes
Chapter 3 Symptoms

• Language: English
• Publisher: Kenneth Kee
• Release date: Jul 10, 2018
• ISBN: 9780463318683

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Cafe-Au-Lait Spots,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Cafe-Au-Lait Spots, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Cafe-Au-Lait Spots)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Cafe-au-lait spots

From Wikipedia

What is a cafe-au-lait spot?

Cafe-au-lait spot is a flat, pigmented birthmark often manifesting as a hyper-pigmented skin patch with a sharp border and diameter of > 0.5 cm.

It is also known as circumscribed cafe-au-lait hyper-melanosis, von Recklinghausen spot, or abbreviated as CALM.

The name cafe au lait is French for coffee with milk and refers to their light-brown color.

They are produced by a collection of pigment-forming melanocytes in the epidermis of the skin.

These spots are typically permanent, and may grow or increase in number over time.

Cafe au lait spots are often benign, not harmful but may be linked with syndromes such as neurofibromatosis type 1 and McCune–Albright syndrome.

Cafe-au-lait spots are normally evident at birth (congenital) or occur in early infancy.

They occasionally become apparent later in infancy, particularly after exposure