Congenital haemangiomas
These are fully formed haemangiomas at birth. There are two sub-types: Rapidly involuting congenital haemangiomas (RICH) and non-involuting congenital haemangiomas (NICH). In both the forms, the proliferative phase occurs in utero. Unlike IH, these are GLUT 1 negative tumours. They manifest as erythematous to violaceous large hemispherical tumours and a peripheral halo of pallor. The surface may show telangiectasia. RICH completely involutes by 12-18 months of age [Figure 4a and 4b]. NICH lesions do not involute over time [Figure 4c and 4d] and hence may require surgical excision or embolization.
Figure 4  (a and b) Congenital haemangioma, (a) RICH at 1 month, (b) after resolution at 7 months of age, (c and d) NICH (courtesy of Anthony J Mancini)