Baby James McCallum is affectionately referred to by his parents as the “little ninja-turtle” after he was born with a “turtle shell” growth caused by a rare skin condition.

James, 19 months, was born with a large growth covering 75% of his back – surprising both his parents and doctors.

His mum, Kaitlyn, says ultrasounds did not reveal anything before she gave birth to him on August 19 at Morton Plant Hospital in Clearwater, Florida, US.

Kaitlyn became concerned when she noticed scabbing and raised areas on what she initially thought was a birthmark, and while she and her husband Tim, 41, waited for a diagnosis, the mole-like growth expanded to cover most of James’s back.

After two months and multiple consultations, little James was diagnosed with giant congenital melanocytic nevus – a rare, non-cancerous skin condition caused by the unusual development of pigment cells before birth.

James’ parents were told the growth could be removed through a series of operations, and he underwent two surgeries in February and May.

These procedures removed most of the nevus so James could finally lie comfortably on his back, and he then underwent tissue expansion to replace the affected area with healthy skin from the remaining skin on his back.

Thankfully, the procedure was successful, and Kaitlyn and Tim hope James will only need one final operation to remove the remaining nevus.

Kaitlyn says James has more mobility and “certainly” seems much more comfortable now that he’s able to lie on his back.

Kaitlyn, from Tampa, Florida, said: “When he was born, my mum, Mary, and Tim both noticed something on his back.

“It looked kind of like a birthmark but had scabbed-over areas – it was a little concerning because it looked unusual.

“The doctors didn’t really know what it was at that point.

“It had started to become thicker and more raised – it seemed like it was growing.

“When he was two months old, a paediatric dermatologist was able to tell us what it was and then began the process of having it removed.”

Before his first surgery in February, James had to undergo an MRI to check whether the growth had extended internally toward his brain or spine.

Kaitlyn said: “At two-and-a-half months old he had to go under anaesthesia to have the MRI done.

“We were so relieved when the results showed there was nothing else going on.”

Kaitlyn and Tim were then eager to have the nevus removed after it began affecting James’ sleeping position.

She said: “We had to speak to a plastic surgeon because the condition carries a higher risk of melanoma.

“They started the removal process and over the course of a couple of months we had two different surgeries to remove most of it.

“It had reached the point where we had to let him sleep on his side because he couldn’t rest his head flat due to how bulky it had become.

“After surgery, he was finally able to lie flat, and he seemed much more comfortable.

“They also tested the removed skin, and the results came back clear, which was wonderful.”

Following the successful surgeries, Kaitlyn and Tim explored tissue expansion after worrying the nevus could return.

According to the NHS, tissue expansion is a procedure that encourages the body to grow extra skin by gradually stretching the surrounding tissue.

Kaitlyn and Tim joined a Facebook support group for families around the world living with the condition to learn more about tissue expansion. They were eventually referred to a specialist.

Through the group, they also learned that nevi can be extremely itchy, explaining why James often rubbed his back against objects.

They also discovered that nevi do not produce sweat glands, meaning they would need to limit James’ time outdoors in hot weather.

Kaitlyn said: “They seem like little things, but they were really important to us.

“Through that group we were referred to a doctor in Chicago.

“We had a virtual consultation to understand exactly what we were dealing with, and then we arranged to begin tissue expansion.

“You can do the expansion process from home. The expanders are placed under the skin by the doctor, and then we injected them with saline once a week. Over time, the healthy skin gradually expanded to replace the nevus.”

The couple joked that they could now “add nurse to our résumé.”

“James was young enough that he didn’t really understand what was happening, and he handled it incredibly well,” Kaitlyn said.

“We started that process in September, and from what the doctors told us, they believe everything can be completed by his second birthday in August.

“The Facebook group is wonderful, and they work with the Nevus Outreach Organisation, which supports incredible research.”

The first round of tissue expansion was a success, and James will return to Chicago in April to have the final expanders placed and gradually expanded throughout the summer.

Kaitlyn said: “The doctor told us once it’s removed, it’s gone. He’ll simply have a few minimal scars.

“He’s so much happier and much more comfortable, and we’ll be so happy to have all of it behind us by the summer.

“This condition often affects the face, so we felt fortunate that it was only on his back.

“Having this removed will give him the best possible quality of life. One day he’ll be able to tell a cool story about it and maybe even joke that it was a shark bite.

“We’ll happily accept a few scars over having to deal with this condition any day.”