What is the diagnosis of a 1-month-old girl presenting with a bright red, raised, lobulated, non-blanching vascular plaque on the right face and scalp, following a dermatomal pattern along the V1 and V2 branches of the trigeminal nerve (fifth cranial nerve), with normal vital signs, growth parameters, magnetic resonance imaging (MRI) of the head, and echocardiography?

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Differential Diagnosis for Infant with Facial Birthmark

  • Single most likely diagnosis
    • Infantile Hemangioma: This is the most likely diagnosis given the bright red, raised, and lobulated appearance of the lesion, which is consistent with a vascular tumor. The fact that it has become more prominent over time and is non-blanching also supports this diagnosis. Infantile hemangiomas are common in infants and often follow a dermatomal pattern, as seen in this case.
  • Other Likely diagnoses
    • Congenital Hemangioma: Although less common than infantile hemangiomas, congenital hemangiomas are present at birth and can have a similar appearance. However, they are typically fully formed at birth and do not have the same growth pattern as infantile hemangiomas.
    • Port-Wine Stain (Capillary Malformation): This is a vascular malformation that can present as a bright red, flat lesion. However, port-wine stains are typically flat and do not have the raised, lobulated appearance of the lesion in this case.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • PHACE Syndrome: This is a rare condition characterized by a large facial hemangioma associated with arterial anomalies, cardiac anomalies, and other features. Although the MRI and echocardiography were normal in this case, it is essential to consider PHACE syndrome due to its potential for serious complications.
    • Kasabach-Merritt Syndrome: This is a rare condition characterized by a vascular tumor (often a kaposiform hemangioendothelioma or tufted angioma) associated with consumptive coagulopathy. Although the lesion in this case does not have the typical features of Kasabach-Merritt syndrome, it is crucial to consider this diagnosis due to its potential for severe bleeding and coagulopathy.
  • Rare diagnoses
    • Kaposiform Hemangioendothelioma: This is a rare, locally aggressive vascular tumor that can present as a red, raised lesion. However, it is typically associated with more severe symptoms, such as bleeding and coagulopathy, which are not present in this case.
    • Tufted Angioma: This is a rare, benign vascular tumor that can present as a red, raised lesion. However, it is typically smaller and more localized than the lesion in this case.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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