Café au lait spots are a type of pigmented skin lesions which are classically described as being light brown in color.
Conditions associated with them include:
neurofibromatosis type 1 (NF1): spots with smooth borders which have been likened to the coast of California, a western state in the USA
McCune-Albright syndrome: typically irregular spots which have been likened to the coast of Maine, a far northeastern state in the USA
fanconi anemia
coffin-siris syndrome