concern about passing on a genetic disease

[jonikins]

I'm 25 years old and I have a large cafe au lait spot on my left upper thigh that practically covers the skin from my knee to my upper buttock.  This mark my mother claims became prominent when I was 4 or 5 as she failed to notice it before then.  I have never had any health problems to suggest that the mark is anything other than a birthmark.  My husbands father also has skin marks called "vitiligo"(?) that consist of a large white mark covering his armpit and an area on his scalp that is white as well. None of his children including my husband have these marks. My concern is that these may be connected and a disease will pass to the children that my husband and I are thinking of having. No one on my side of the family or on my husbands side have had any health problems suggesting a genetic disease; yet I wonder could the incidence be higher for my children since it may pass through me and my husbands side. I'd like to think the marks are harmless. Is genetic testing advisable?

[Jordanna Joaquina, MS, CGC]

Cafe-au-lait spots themselves do not cause health issues. Having multiple spots has been linked to a number of genetic conditions. We recommend that you meet with a dermatologist for evaluation.

Vitiligo is a separate skin condition. This skin disorder is multifactorial, which means that both genetic and non-genetic factors contribute to developing this condition. We know that vitiligo runs in some families. In these families, there are typically multiple affected people in different generations.

We recommend that you meet with a genetic counselor who can review your personal and families histories in order to provider a more specific and accurate risk assessment. A genetic counselor can be found at the National Society of Genetic Counselor website or through companies like mine, AccessDNA.