Congenital craniofacial deformities

4. A 4-month-old boy is brought in by his mother for evaluation of a “birthmark” on his forehead that has become more prominent with time. The child complains a bit when the lesion is touched.

His mother gives a history of a normal full-term pregnancy with an uneventful delivery. Other than the skin lesion, there have been no other known problems with the child’s health.

Diagnosis: Most first-year medical students could tell you this was a case of an infantile hemangioma—but within the past five years, the categorization and treatment of hemangiomas have changed rapidly.

Hemangiomas are benign and usually self-involuting vascular tumors. They are distinct from the family of permanent congenital vascular lesions, such as port wine stains. About 80% occur on the face or neck and more commonly in females. Those that occur near the skin’s surface tend to be bright red, while those of deeper origin are more bluish. Hemangiomas can also manifest in extracutaneous areas (eg, the liver); these are usually detected via imaging.

For more information, see “A New Approach to “Birthmarks” Clin Rev. 2016;26(3):W1.

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Infantile Hemangiomas Increasing, Linked to Prematurity, Low Birth Weight Bruce Jancin, Family Practice News Digital Network