Differential Diagnosis for a 6 Month Old Blanchable Oval Lesion on the Face

• Single Most Likely Diagnosis
  • Hemangioma: This is the most common benign vascular tumor in infants, often appearing as a blanchable, oval lesion on the face. It typically presents within the first few weeks of life and can grow rapidly during the first year.
• Other Likely Diagnoses
  • Port Wine Stain (early presentation): Although typically non-blanchable, some early presentations might appear blanchable. It's a congenital vascular malformation that can appear as an oval lesion on the face.
  • Congenital Melanocytic Nevus: These are moles present at birth, which can be oval and may appear on the face. However, they are usually pigmented and might not always be blanchable.
• Do Not Miss Diagnoses
  • Kaposi's Sarcoma: Although extremely rare in infants, it can present as vascular lesions. Given its potential severity and association with HIV or immunocompromised states, it's crucial not to miss this diagnosis.
  • Infantile Hemangioendothelioma: A rare vascular tumor that can appear similar to hemangiomas but may have a more aggressive course.
• Rare Diagnoses
  • Tufted Angioma: A rare, benign vascular tumor that can appear as a blanchable lesion. It's less common than hemangiomas and might have a more persistent course.
  • Glomuvenous Malformation: A rare congenital vascular malformation that can appear as a blanchable, oval lesion, though it's typically more nodular and less common than hemangiomas.