Bilateral large perilabial/perineal acquired kissing hemangiomas

A 13-year-old girl presented with two blue-purple, non-pulsating kissing nodules involving the labia majora, measuring approximately 1.0 × 1.5 cm. She also exhibited two smaller lesions in the perineal region with unknown disease onset, which were accompanied by mild pruritus and discomfort in the genital/vaginal area, without bleeding. An international normalized ratio (INR) of 1.41 was noted. Magnetic resonance imaging (MRI) of the pelvis and perineum showed a superficial vascular formation in the perineum. Biopsy confirmed hemangioma, and the diagnosis of bilateral large perilabial/perineal acquired kissing hemangiomas was made.