While infantile hemangiomas are a very common lesion seen in infants and young children, congenital hemangiomas are much more rare and have been only recently described. Two types of congenital hemangiomas exist: rapidly involuting congenital hemangiomas and noninvoluting congenital hemangiomas. The goal of this article is to describe rapidly involuting and noninvoluting congenital hemangiomas as they differ from infantile hemangiomas in their presentation, natural history, histopathologic features, and treatment.
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Nascent infantile hemangioma showing distinct area of patterned vasoconstriction at birth (A) and same patient at age 3 months with plaquetype superficial hemangioma (B).
Nascent infantile hemangioma showing vasoconstriction and a bruiselike area on left medial thigh.
Growth curves for rapidly involuting congenital hemangioma (RICH), noninvoluting congenital hemangioma (NICH), and infantile hemangioma (IH) (reprinted from J Am Acad Dermatol7 with permission from American Academy of Dermatology, Inc).
Typical rapidly involuting congenital hemangioma at birth (A) and same patient at age 10 months showing complete involution with anetodermic residual skin (B).
Rapidly involuting congenital hemangioma at 1 week of age (A) and same patient at age 4 months with almost complete involution (B).
One-month-old boy with rapidly involuting congenital hemangioma on left mandible (A) and same patient at age 4 months (B).
Newborn with rapidly involuting congenital hemangioma on right wrist (A) and same patient at age 4 weeks with grayish nodule with early involution in center (B).
Patient who presented with typical rapidly involuting congenital hemangioma at birth followed by rapid involution to this lesion at age 2 years, which has features of noninvoluting congenital hemangioma and has persisted.
Typical bossed plaque of noninvoluting congenital hemangioma with coarse surface telangiectasia.
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