By Gary M. White, MD

Two types of congenital hemangiomas occur.

Some RICH only partially involute, leaving a NICH [JAAD 2014;70:899-903].


A vascular tumor, fully formed at birth is seen. It never involutes. Two types have been described. A patch type, characterized by a flat or slightly atrophic surface and a nodular/plaque type. The surface in both the nodular and patch types may have a hypopigmented color with telangiectasias throughout.


Most NICH do not require treatment. Surgical resection is an option in selected cases [JAAD 2014;70:899-903], but may be complicated by incomplete excision as well as intraoperative and postoperative bleeding. Other described treatment options include sclerothreapy with surgery [Phlebology 2014;29 :4–8], endovascular particulate embolization, tissue cauterization, vascular laser therapy and cryotherapy to control recurrent episodes of oral bleeding.


An 18 month old boy with a NICH of the face that was surgically removed. JAAD Case Rep. 2016 May; 2(3): 199–201.


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