A 7-day-old boy with a congenital vascular nodule.

born via spontaneous vaginal delivery. The pregnancy was uncomplicated, and there was no maternal history of preeclampsia or placental abnormalities. Vascular abnormalities were not seen on prenatal ultrasounds. Review of systems was unremarkable. There is no family history of vascular anomalies. On physical exam, he was a well-developed, well-nourished infant with a 4.6 cm x 4.2 cm discrete, warm vascular nodule with a rim of pallor and central prominent telangiectasias on his trunk (see Figure 1). No bleeding or ulceration was noted. There was no pain on palpation. The remainder of his physical exam was unremarkable, including a normal cardiac and abdominal exam. Follow-up evaluation of this child in 2 months revealed softening of the lesion, decreased erythema, and warmth. Further follow-up evaluation, which was 6 months after initial presentation, showed a fl at, telangiectatic plaque with a rim of pallor (see Figure 2). Figure 1. Initial presentation at 7 days of life with a warm, vascular nodule.