Cleft Lip Appearance Secondary to Ulcerating Hemangioma

Infantile hemangiomas are frequently observed as soft tissue growths during infancy. Although many cases tend to resolve without treatment, some may lead to complications that require prompt management. Here, we present a case of a lip hemangioma in an infant that resembled a cleft lip in the newborn period and resulted in significant early and delayed complications. A 40-day-old female infant was brought with complaints of a reddish raised lesion over her upper lip. The lesion started as a small cleft on day 14 of life, which subsequently increased in size rapidly and ulcerated. She was having feeding difficulty due to pain and not gaining weight. She was admitted with a working diagnosis of complicated infantile hemangioma with ulcer. She was evaluated for internal hemangiomas and syndromic association in view of a large segmental involvement. She was started on oral propranolol along with local wound care and discharged with advice to follow up. The lesion gradually involuted in five months' time. Currently, she is three years old with sequelae in the form of atrophy, scar, fibrofatty remnant, and loss of lip contour, awaiting plastic surgery. The current case report highlights the rare presentation of an infantile hemangioma ulcerating in the early months of life, resulting in the appearance of a cleft and the need for timely medical intervention before ulceration develops to avoid long-term sequelae and surgery.