A 6-week-old infant has a bright red, raised, rubbery lesion about 2 cm in diameter on the occiput. Which condition is most likely?

A 6-week-old infant has a bright red, raised, rubbery lesion about 2 cm in diameter on the occiput. Which condition is most likely?

• A. Malignant melanoma
• B. Port-wine stain
• C. Capillary hemangioma
• D. Burns

Answer: (C)

This presentation fits an infantile capillary hemangioma, a common benign vascular tumor in newborns. These lesions often appear within the first weeks of life, are bright red and raised (sometimes described as a “strawberry” hemangioma), and on the scalp or occipital region they feel rubbery to the touch. They typically undergo rapid growth over the first several months and may blanch with pressure, reflecting their vascular nature. Over time they often involute spontaneously over years. Port-wine stains are congenital capillary malformations that are present at birth and remain flat, usually persisting or darkening rather than becoming raised. Burns would require a history of heat injury and usually present with blistering and scarring rather than a smooth, raised vascular lesion. Malignant melanoma is exceedingly rare in this age group and would not present as a bright red, rubbery lesion typical of a strawberry hemangioma.

This presentation fits an infantile capillary hemangioma, a common benign vascular tumor in newborns. These lesions often appear within the first weeks of life, are bright red and raised (sometimes described as a “strawberry” hemangioma), and on the scalp or occipital region they feel rubbery to the touch. They typically undergo rapid growth over the first several months and may blanch with pressure, reflecting their vascular nature. Over time they often involute spontaneously over years.

Port-wine stains are congenital capillary malformations that are present at birth and remain flat, usually persisting or darkening rather than becoming raised. Burns would require a history of heat injury and usually present with blistering and scarring rather than a smooth, raised vascular lesion. Malignant melanoma is exceedingly rare in this age group and would not present as a bright red, rubbery lesion typical of a strawberry hemangioma.