RICH (Rapidly Involuting Congenital Hemangioma) with Fetal Involution

Abstract

A term newborn was evaluated for the presence of a lesion resembling an involuting hemangioma; dermoscopy showed some residual ectasic capillaries, consistent with the diagnosis. At 5 months, lesion appeared in further light regression, comparable to that of a classical capillary hemangioma at 2 years of life. Pediatric hemangiomas are classified into infantile and congenital hemangioma. Infantile hemangiomas typically are very pale at birth, proliferate in the first months of life and then gradually involute throughout childhood. Congenital hemangiomas are further subclassified into rapidly involuting (RICH) and non-involuting (NICH) congenital hemangioma. Recently, a new variant of RICH showing fetal involution has been described. The prominent part of the life cycle of this variant of RICH (ie, proliferation and rapid involution) seems to start prenatally, whereas regression in typical RICH usually occurs in early infancy.Our case seems to confirm the existence of such variant of RICH.