Congenital midline nodules on the chin and sternum

A 5-day-old Black male full-term neonate born via vacuum-assisted delivery for non-reassuring fetal heart rate presented with two asymptomatic midline lesions. On the submental chin, there was a soft, erythematous dome-shaped nodule measuring 0.8 centimeters with a circumferential ring of brown pigmentation; on the upper sternum, there was a skin-colored 2-millimeter dome-shaped nodule (Figure 1). There was no history of seizures, ophthalmologic findings, abnormalities in head circumference, height, weight, or limb size. Newborn screening examination was unremarkable. Ultrasound of the submental chin revealed a heterogeneously hypoechoic structure with a peripheral soft tissue rind. Skin biopsies were performed from both lesions.