Infantile hemangioma precursor lesions on day of life 1: A Mayo Clinic retrospective case series.

Background: Infantile hemangiomas (IHs), the most prevalent vascular tumors in infancy, are generally understood to be absent at birth, appearing in the initial weeks of life during their proliferative stage. While the classic presentation is recognizable, the precursor lesion of IHs may be misinterpreted as other entities, including vascular malformations.

Methods: A retrospective, single-center study was conducted, examining neonates with photographed IH precursor lesions on day of life (DOL) 1 and matured classical IHs. The study spanned from 2017 to 2023.

Results: The case series is comprised of nine neonates all exhibiting precursor lesions on DOL 1. A comparative display of photographs featuring precursor lesions and classic IH is presented. Further tabulated information for each case includes IH locations, subsequent treatment modalities, and further diagnostic workup if necessary.

Conclusions: Improving recognition of precursor lesions increases diagnostic accuracy, decreasing unnecessary workup. This, in turn, allows dermatologists to confidently employ close follow-up management strategies. Additionally, in cases of extensive involvement, recognition of the precursor lesion allows for expedited investigation for syndromes such as PHACE (posterior fossa malformations, hemangioma, arterial anomalies, coarctation of the aorta/cardiac defects, and eye abnormalities) and LUMBAR (lower body IH, urogential anomalies, ulceration, myelopathy, bony deformities, anorectal malformations, arterial anomalies, and renal anomalies).