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The Case
A term female newborn presents with a solitary, well-circumscribed black lesion on the dorsum of the tongue that measures 0.5 × 0.5 cm (Figure 1).
Prenatal history:
20-year-old, gravida 3 para 0 (1 preterm birth, 1 loss before 20 weeks, and 1 living child), Hispanic mother
All prenatal laboratory results are within normal limits
Prenatal ultrasonography revealed no structural abnormalities
Denies any exposure to drugs, alcohol, or toxins
Uneventful prenatal course
Birth History:
Female infant born via extramural normal spontaneous vaginal delivery by emergency medical services (EMS) personnel at 39 weeks of gestation with Apgar scores of 7 and 9 at 1 and 5 minutes, respectively
Birth weight of 2925 g
Infant brought to the hospital via EMS with a presenting temperature of 97.1°F (36.2°C)
Admitted to the neonatal intensive care unit in view of extramural delivery and hypothermia
Case Progression
Vital Signs:
Temperature: 98.4°F (36.9°C)
Respiratory rate: 58 breaths/min
Heart rate: 131 beats/min
Blood pressure: 77/45 mm Hg
Oxygen saturation: 99% on room air
Birth weight: 2925 g (25th percentile)
Length: 50 cm (50th percentile)
Head circumference: 33.5 cm( 25th percentile)
Physical Examination:
Head: Normocephalic, anterior fontanelle soft and flat, left parietal cephalhematoma 3 …
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