[Noninvoluting congenital hemangioma: 2 cases]

Hemangiomas (or immature hemangiomas) are characterized by a stereotyped 3-phase evolution: proliferation, stabilization and regression. The rare congenital hemangiomas are present at birth and regress spontaneously more rapidly. However, certain congenital hemangiomas, described recently as "noninvoluting congenital hemangiomas", evolve differently and do not regress. We report two cases.

Two adolescents aged 16 and 17 were born with a congenital hemangioma. Its evolution during childhood was marked by the progressive collapse of the lesion and lightening of the skin. After stabilizing, a round, centrally involuted lesion persisted with numerous telangiectasia on the surface and peripheral varicosities. The lesion was hot but no pulsation or murmur were observed. Doppler sonography revealed a rapid flowing lesion, limited to the cutaneous areas. Magnetic resonance imaging, conducted in one case, showed a hypersignal area limited to the skin.

Noninvoluting congenital hemangiomas can be differentiated from classical congenital hemangiomas by their partial regression, stereotyped clinical aspect and a certain activity after stabilization. All the clinical, histological and imaging data support a vascular malformation with proliferative component, rather than a true hemangioma. Whenever possible, treatment is surgical. Knowledge of the existence of this type of angioma is important, and the dermatologist should be careful when reassuring parents of children presenting with congenital hemangioma.