Due to their complex etiology and pathogenesis, hemangioma-related syndromes, such as LUMBAR and PHACE, present diagnostic and therapeutic challenges. Despite advances, standardized diagnostic criteria, screening protocols, and treatment options still need to be developed. We report a rare case of a 1-month-old patient with nonspecific symptoms, including failure to thrive and poor feeding, associated with lumbosacral ulcers. The diagnosis revealed overlapping features of LUMBAR and PHACE syndromes, highlighting the broad phenotypic spectrum and suggesting a potential common etiology. This case underscores the need for heightened clinical suspicion among general practitioners, dermatologists, and vascular physicians to manage these conditions. Propranolol is widely used for treating infantile hemangiomas, but due to its side effects, alternative therapies need to be explored. Emerging treatments, such as Atenolol, Timolol, Carteolol, and pulsed dye lasers, offer promise but require further investigation. However, the most crucial aspect is the need for ongoing research into the mechanisms of action, clinical applications, and side effects of current and alternative treatments. This research is essential for developing a comprehensive, safe management algorithm for both low- and high-risk infantile hemangiomas. It demands sustained engagement and commitment from the medical and research communities, ultimately improving patient outcomes and advancing medical knowledge.
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