A 2-Week-Old Boy Is Brought to the Office for Evaluation

A 2-week-old boy is brought to the office for evaluation of a skin lesion.  His parents first noticed the lesion on the right side of his forehead a week ago.  His mother says, "It doesn't seem to hurt him, but it is bright red and I am afraid it could bleed."  The parents say there is no history of trauma or other skin lesions.  The patient was born at term via spontaneous vaginal delivery with no complications, and he has no known medical conditions.  His maternal aunt has a history of melanoma, and his paternal grandmother has had several basal cell carcinomas.  Temperature is 36.7 C (98 F) , blood pressure is 75/45 mm Hg, pulse is 135/min, and respirations are 40/min; pulse oximetry is 99% on room air.  Physical examination shows a fair-skinned, well-nourished infant with a nontender lesion on the forehead that is 1.5 cm in diameter.  There is no ulceration or bleeding, and the remainder of the skin examination is normal.  Cardiac examination reveals a normal rate and rhythm with no murmurs.  The lungs are clear to auscultation.  Which of the following is the most accurate statement regarding this patient's condition?

A) Lesions will spread, evolve to pustules, and disappear in a week.
B) Proliferation and growth of the lesion is common in the first year of life.
C) The growth is benign but will persist until surgically removed.
D) This blanchable lesion is benign and common on the forehead, neck, and eyelids of newborns.
E) This lesion is often associated with underlying central nervous system vascular malformations.