FIGURE 69.17 Dark blue patches on the buttocks and back of infant with dermal melanocytosis, formerly called Mongolian spots Additionally, certain syndromes such neurofibromatosis, are associated with early-onset pigmented skin lesions Patients with this disease can initially present with café-au-lait spots, which are flat, nonpalpable, coffee-colored lesions of varying size and shape When six or more lesions are present, greater than 0.5 cm in size, neurofibromatosis should be considered The Peutz–Jeghers syndrome is a dominantly inherited condition that includes freckle-like lesions of the lips, nose, buccal mucosa, fingertips, and subungual areas associated with polyps in the small intestine, stomach, or colon Melena and intussusception are the chief complications that may develop, usually in the second decade of life McCune–