A 3-month-old developed a soft, red, ulcerated tumor directly distal to the left axilla at the mid-axillary line.
This hemangioma possessed both superficial and deep dermal components. Hemangiomas are rarely present at birth but develop in up to 10% of infants by 4 weeks of age. Seventy-five percent of hemangiomas occur in girls, and premature infants are more commonly affected. Lesions first appear as telangiectasias or red macules but quickly grow into 0.5-4cm wide red compressible tumors. Hemangiomas typically stop growing by 6-12 months of age. Signs of involution including graying of the surface and flattening of the deeper component may subsequently develop. Regression occurs in 25% of patients by 2 years of age, 40% by 4 years of age, 60% by years of age, and 95% by adolescence, but scarring, loose skin, and/or telangiectasias may persist in 30-50% of patients.
5.5 cm dome shaped purple red tumor with ulceration and exudate