{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T20:51:09Z","timestamp":1760043069027},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T00:00:00Z","timestamp":1469664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The presence of six or more caf\u00e9 au lait (<jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content>) spots is a criterion for the diagnosis of neurofibromatosis type 1 (<jats:styled-content style=\"fixed-case\">NF<\/jats:styled-content>\u20101). Children with multiple <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> spots are often referred to dermatologists for <jats:styled-content style=\"fixed-case\">NF<\/jats:styled-content>\u20101 screening. The objective of this case series is to characterize a subset of fair\u2010complected children with red or blond hair and multiple feathery <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> spots who did not meet the criteria for <jats:styled-content style=\"fixed-case\">NF<\/jats:styled-content>\u20101 at the time of their last evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a chart review of eight patients seen in our pediatric dermatology clinic who were previously identified as having multiple CAL spots and no other signs or symptoms of NF\u20101.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We describe eight patients ages 2 to 9 years old with multiple, irregular <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> spots with feathery borders and no other signs or symptoms of <jats:styled-content style=\"fixed-case\">NF<\/jats:styled-content>\u20101. Most of these patients had red or blond hair and were fair complected. All patients were evaluated in our pediatric dermatology clinic, some with a geneticist. The number of <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> spots per patient ranged from 5 to 15 (mean 9.4, median 9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A subset of children, many with fair complexions and red or blond hair, has an increased number of feathery CAL spots and appears unlikely to develop <jats:styled-content style=\"fixed-case\">NF<\/jats:styled-content>\u20101, although genetic testing was not conducted. It is important to recognize the benign nature of <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> spots in these patients so that appropriate screening and follow\u2010up recommendations may be made.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.12936","type":"journal-article","created":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T04:27:33Z","timestamp":1473136053000},"page":"526-529","source":"Crossref","is-referenced-by-count":6,"title":["Multiple Caf\u00e9 au Lait Spots in a Group of Fair\u2010Skinned Children without Signs or Symptoms of Neurofibromatosis Type 1"],"prefix":"10.1111","volume":"33","author":[{"given":"Jessica","family":"St. John","sequence":"first","affiliation":[{"name":"University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Summe","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine University of Massachusetts Medical School and UMass Memorial Health Care Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Csikesz","sequence":"additional","affiliation":[{"name":"Dermatology Professionals North Attleboro Massachusetts"},{"name":"Department of Dermatology Roger Williams Medical Center Providence Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Wiss","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine University of Massachusetts Medical School and UMass Memorial Health Care Worcester Massachusetts"},{"name":"Division of Dermatology Department of Pediatrics University of Massachusetts Medical School and UMass Memorial Health Care Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly","family":"Hay","sequence":"additional","affiliation":[{"name":"Division of Genetics Department of Pediatrics University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Belazarian","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine University of Massachusetts Medical School and UMass Memorial Health Care Worcester Massachusetts"},{"name":"Division of Dermatology Department of Pediatrics University of Massachusetts Medical School and UMass Memorial Health Care Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1983.tb01093.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80713-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(95)90338-0"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.57.8.631"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.41.217.316"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(95)91331-9"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000248009"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1953.00240180067008"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2009.180"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.3.608"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2010.07.002"},{"key":"e_1_2_6_13_1","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1542\/peds.90.6.924","article-title":"Diagnostic outcome in children with multiple caf\u00e9 au lait spots","volume":"90","author":"Korf B","year":"1992","journal-title":"Pediatrics"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2009.169"},{"key":"e_1_2_6_15_1","volume-title":"Hurwitz clinical pediatric dermatology","author":"Paller AS","year":"2016"},{"key":"e_1_2_6_16_1","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1001\/archderm.1994.01690110091015","article-title":"Familial multiple cafe au lait spots","volume":"130","author":"Arnsmeier SL","year":"1994","journal-title":"Arch Dermatol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5070\/D33D56C2Q8","article-title":"Multiple or familial cafe\u2010au\u2010lait spots is neurofibromatosis type 6: clarification of a diagnosis","volume":"18","author":"Madson JG","year":"2012","journal-title":"Dermatol Online J"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.32.12.985"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320450518"},{"key":"e_1_2_6_20_1","unstructured":"StevensonD ViskochilD MaoR.Legius Syndrome. 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