Diffuse neonatal hemangiomatosis with a single atypical cutaneous hemangioma

Unusual Case of Diffuse Neonatal Hemangiomatosis Case Report and Literature Review

“…Typically, the presence of multiplied hemangiomas on the skin has long been recognized as a marker of hepatic hemangiomas and should be systematically investigated by liver ultrasound. 1 , 4 Historically, vascular lesions affecting multiple areas in infants have been classified under terms like “diffuse neonatal hemangiomatosis” and “benign neonatal hemangiomatosis.” In 1970, Holden and Alexander introduced 3 essential diagnostic criteria for identifying DNH; onset during the neonatal period, absence of malignancy indicators, and the involvement of 3 or more distinct organ systems. 5 Among these, the liver is frequently impacted, followed by the brain; which appear to be the case here, since the infant has shown a hemorrhagic meningeal bleed.…”

“…Despite the benign nature of the histology, the mortality rate associated with DNH ranges from 50% to 90%. 1 This high mortality is attributed to diverse complications, including congestive heart failure due to extensive arteriovenous shunting, liver failure, consumptive coagulopathy, and hemorrhaging. Characteristically, skin lesions manifest as red papules or nodules, measuring between 0.5 and 1.5 cm in size, with quantities varying from 10 to 100.…”

“…Characteristically, skin lesions manifest as red papules or nodules, measuring between 0.5 and 1.5 cm in size, with quantities varying from 10 to 100. 1 , 2 …”

“…The appearance of cutaneous hemangiomas may raise suspicion, leading to an investigation into potential visceral involvement. 1 , 2 Lower gestational age and birthweight are associated with a higher risk of infantile hemangioma. Despite being a benign vascular tumor, DNH can lead to life-threatening complications, including conditions such as congestive heart failure, abdominal compartment syndrome, consumptive thrombocytopenia, and consumptive hypothyroidism.…”