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Special Feature
Sep 2012

Picture of the Month—Quiz Case

Author Affiliations


Author Affiliations: Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Alberta, Canada (Dr Prajapati); and Division of Vascular and Interventional Radiology, Department of Radiology (Dr Dillon), and Dermatology Program, Division of Immunology, Department of Medicine (Drs Huang, Gellis, and Liang), Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts.

Arch Pediatr Adolesc Med. 2012;166(9):863. doi:10.1001/archpediatrics.2012.658

A 3-month-old girl was referred to our Vascular Anomalies Center for assessment of a rapidly enlarging left hand mass. Although present at birth as a mild localized swelling, significant growth was not noted until approximately 6 weeks of age. The infant's medical, surgical, and family history were unremarkable, and she was initially evaluated by her pediatrician, who suspected a vascular tumor or malformation.

Physical examination revealed a solitary, 2.5 × 3 × 2.5-cm, firm, nonmobile, subcutaneous nodule with slight erythematous to blue hue and overlying telangiectasia protruding from the left hypothenar region (Figure 1). A handheld Doppler device detected fast blood flow at the periphery. There were no other skin abnormalities.