Infant with red eyelid lesion
The rapid growth of this lesion provided an important clue in the diagnosis.
Pyogenic granulomas are usually small (< 1 cm), sessile or pedunculated red papules or nodules. They are friable, bleed easily, and grow rapidly.
Capillary malformations can manifest at birth as flat, red/purple, cutaneous patches with irregular borders that are painless and can spontaneously bleed; they can be found in any part of the body but mainly occur in the cervicofacial area.5 Capillary malformations are commonly known as stork bites on the nape of the neck or angel kisses if found on the forehead. Lateral lesions, known as port wine stains, persist and do not resolve without treatment.5
Tufted angioma and kaposiform hemangioendothelioma manifest as expanding ecchymotic firm masses with purpura and accompanying lymphedema.4 Magnetic resonance imaging, including magnetic resonance angiography, is recommended for management and treatment.4
Venous malformations can be noted at birth as a dark blue or purple discoloration and manifest as a deep mass.5 Venous malformations grow with the patient and have a rapid growth phase during puberty, pregnancy, or traumatic injury.5
Arteriovenous malformations (AVMs) may be present at birth as a slight blush hypervascular lesion. AVMs can be quiescent for many years and grow with the patient. AVMs have a palpable warmth, pulse, or thrill due to high vascular flow.5
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