Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist and I read your mail with diligence and saw the picture sent by you.
I wish there was no light behind your shoulder the picture could have come well. Nevertheless brown spots which you referred to are visible/. Coming straight to your questions: These brown spots looks to me like Cafe au lait spots
Causes, incidence, and risk factors
Cafe-au-lait spots may occur in people with the genetic disorder, neurofibromatosis.
Nearly everyone has moles, which usually appear after birth.
Mongolian spots are more commonly seen in darker-skinned populations.
Symptoms
Each type of birthmark has its own appearance:
Cafe-au-lait spots are light XXXXXXX the color of coffee with milk.
Moles are small clusters of colored skin cells.
Mongolian spots (also called Mongolian blue spots) are usually bluish or bruised-looking. They usually appear over the lower back or buttocks, but can also appear in other areas, including the trunk or arms. These do not appear to be Mongolian spots.
Other symptoms of birthmarks:
Abnormally dark or light skin
Contain hair
Skin lesion

Skin lumps

Textured -- smooth, flat, raised, or wrinkled

Signs and tests
Diagnosis is usually made based on the appearance of the skin area. A biopsy may be performed to look for cancerous changes.

Treatment

Treatment varies depending on the type of birthmark and related conditions. Usually no treatment is needed for the birthmark itself.

Large birthmarks that affect your appearance and self-esteem may be covered with special cosmetics.

Moles may be removed surgically if they affect your appearance or have an increased cancer risk. Discuss your options with your doctor to decide how and when to remove any moles.

Support Groups

Nevus Outreach -- WWW.WWWW.WW
Expectations (prognosis)

Large moles that are present at birth (congenital nevi) are more likely to become skin cancer (malignant melanoma). This is especially true if the mole covers an area larger than the size of a fist. The cancer risk is related to the size, location, shape, and color of the mole.

Mongolian spots may persist for months or years. They do NOT become cancer or develop other symptoms.

Complications

Skin cancer

Psychological effects, if the birthmark is prominent

Calling your health care provider

Have any birthmarks examined by a health care provider. Report any changes in the birthmark to your health care provider, including:

1.Bleeding

2.Color change

3.Inflammation

4.Itching

5.Open sore (ulceration)

6.Pain

5.Size change

7. Texture change
I hope that answers your questions. I still do not know why you chose congenital heart disease. If that has been diagnosed yes there is some association but you will have to tell us what the you have been told about heart disease so that an answer can be provided. Good luck.
If you have any more query I will be most happy to answer it.
Regards
Dr Anil Grover,
Cardiologist & Internist
M.B.;B.S, M.D. (Internal Medicine) D.M(Cardiology)

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