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Célia Silva, Carlos Mendes, Luísa Sousa and Humberto S Machado*
Background: The Mongolian spot (MS) is a congenital macula of blue-gray colour usually located on the sacrococcygeal region, but may have atypical locations such as the back and more rarely the limbs. Case report: The authors describe a case of an infant male, born from a monitored pregnancy without complications, whose skin objective examination showed a Mongolian spot occupying the entire lower back region and lower limbs with many similar spots of different sizes and locations as well as on the back of the right hand. Further physical examination appeared to be normal. Discussion: The knowledge of normal variants is crucial in clinical practice of the family doctor, particularly in child health consultation. This atypical skin colouration arises with relative frequency in our population and although it does not seem strange in the usual location, the appearance in atypical locations can be a sign of other associated pathologies, and if they had not been observed at birth, they can be an alert for eventual child abuse. Conclusion: The early diagnosis of the MS and the follow-up and monitoring of the child’s development is crucial to assess the evolution of pigmentation, which usually involutes in early childhood but can persist into adulthood, especially if there were multiple spots and locations.