Perineal congenital ulcerated infantile haemangioma, with minimal proliferative phase and rapid involution. A new morphological variant of Ih?

BACKGROUND: Ulceration generally occurs after several weeks or months from classical infantile haemangioma(IH) onset, but less commonly, it may be the initial presentation of IH. OBJECTIVE: We describe 4 cases of unusual IH presenting with congenital or early perineal ulceration, subsequent minimal growth and rapid involution. METHODS: We report gestational, delivery, clinical and histological data and treatments. RESULTS: A diagnosis of ulcerated IH was made in the first case by histopathology and in the other cases on account of the same clinical appearance, particularly the presence of an angiomatous border . Ulceration quickly healed with topical treatment and was followed by a minimal IH proliferative phase limited to the vascular border and a complete involution within the first year of life. DISCUSSION: Perineal congenital ulcerated IH with minimal proliferative phase and rapid involution may be a morphological variant of IH for its peculiar presentation and growth pattern, but further studies are needed to clarify its pathogenesis.