Question of the Week # 475

A 2-week-old infant is brought to the office for a regular postnatal follow-up. She was born after an uneventful term pregnancy to a 29-year-old G2P2 woman. Mother reports that the infant is feeding well and seems active. No evidence of any fever. The parents are worried about the ‘rash’ that appeared over the infant’s left cheek. On examination, a lesion is noted on the infant’s left cheek as shown below. Vital signs are within normal limits. What is the most appropriate next step in management of this finding?

lesion

A Surgical excision of the entire lesion
B Biopsy of the lesion
C Laser removal of the lesion
D Reassurance and observation
E Topical 5-fluoro-uracil

9 Responses

  1. D?

  2. B ?

  3. How can i know the answer ?

    • Answer D:
      A capillary hemangioma (also known as ‘strawberry hemangioma’) is the most common variant of hemangioma which appears as a raised, red, lumpy area of flesh anywhere on the body, but most commonly over the face and neck. It may grow rapidly, before stopping and slowly fading. Some are gone by the age of 2, about 60% by 5 years, and 90–95% by 9 years. The most appropriate step in management is reassurance and observation – if the hemangioma does not disappear, laser treatment is most commonly recommended. (Answer C).

      Answers A and B:
      Surgical excision is less commonly used than laser removal. Regardless of the method, this would not be the next step in management.

      Answer E:
      Topical cytotoxic drugs are not used in the management of hemangiomas.

      Edmonds JL. Chapter 7. Hemangiomas of Infancy & Vascular Malformations. In: Lalwani AK. eds. CURRENT Diagnosis & Treatment in Otolaryngology—Head & Neck Surgery, 3e. New York, NY: McGraw-Hill; 2012.

  4. D

  5. Thank you for the explanation

  6. Biopsy

  7. D, Totally agreed with the explanation above.

  8. D.

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