Minimal Spinal Dysraphism vs. Pigment Nevus
Left picture: In fact, here, a minimal spinal dysraphism is present, confirmed by x-ray and surgery; notice the skin retraction directly over the midline as a further indication. Right picture: These are two examples of pigment nevus. Although pigment nevus occurs also in minimal spinal dysraphism, the site of the pigment nevi lateral of the midline speaks against such a clinical diagnosis. Again, look at the picture at the top with the site lateral of, and the picture at the bottom with the site below the sacrum.
Left picture: A protruding cutaneous hemangioma is visible over the sacrum of a 5-month-old boy with multiple focuses. Right pictures: A transverse brown spot is present in this 11.5-year-old boy, running on the right side of the midline above the the buttock to the lateral side, and visible in the picture at the top. In the bottom picture of a 4.7-year-old girl the same is true for the left side, in which the nevus ends in the buttock. Left picture: The examiner considers an active and progressive cutaneous hemangioma.