A 2-week-old boy has an elevated lesion over the genital area as seen in the image below: Which of the following is the most likely natural course of this lesion?

Question

A 2-week-old boy has an elevated lesion over the genital area as seen in the image below:  Which of the following is the most likely natural course of this lesion?

Quizplus · Accepted Answer

11ec160b_38f6_0046_9249_c7217c472871_MD0001_00 This child has an infantile hemangioma, a common, benign vascular tumor composed of closely packed capillaries. Infantile hemangiomas are not usually apparent at birth and typically present in the first few days to weeks of life as bright red, raised, and sharply demarcated plaques. They can arise anywhere in the body and usually occur as a single lesion on the skin and subcutaneous tissue. Less commonly, multiple cutaneous hemangiomas may be present, increasing the risk for visceral (eg, hepatic) lesions. The natural progression of hemangiomas begins with proliferation in infancy due to growth of blood vessels within the hemangioma. Following the proliferative phase, an involution phase occurs, in which the lesion spontaneously regresses (Choice B). During involution, the hemangioma dulls in color and softens, eventually resulting in complete resolution in early childhood in most cases. (Choice C) Port-wine stain, or nevus flammeus, is a capillary malformation that begins as a flat, unilateral pink patch that grows proportionally with the child and may evolve into a deep purple, thickened, nodular lesion. Port-wine stains do not regress in size. (Choice D) Nevus simplex is a flat, pink, blanching vascular lesion that commonly occurs on the eyelids, forehead, and nape of the neck. These lesions are benign and typically regress in early childhood. (Choice E) A cherry angioma is a vascular lesion characterized by a proliferation of capillaries that remain stable in size. However, this lesion is typically small (<0.5 cm) and develops in older adults, not infants. Educational objective: Infantile hemangioma is a common, benign vascular tumor that presents soon after birth as a bright red, raised, sharply demarcated plaque. The natural course of hemangiomas is proliferation in infancy followed by regression in early childhood. __________ References: Hemangioma. (http://www.ncbi.nlm.nih.gov/pubmed/30855820)

A 2-Week-Old Boy Has an Elevated Lesion Over the Genital