birth, proliferate in the first months of life and then gradually
involute throughout childhood. Congenital hemangiomas are further
subclassified into rapidly involuting (RICH) and non-involuting
(NICH) congenital hemangioma. Recently, a new variant of RICH
showing fetal involution has been described. The prominent part
of the life cycle of this variant of RICH (ie, proliferation and rapid
involution) seems to start prenatally, whereas regression in typical
RICH usually occurs in early infancy.Our case seems to confrm the
existence of such variant of RICH.
Key words: Congenital hemangioma; Pediatric dermatology; Perina-
tology; Neonatology
© 2019 The Author(s). Published by ACT Publishing Group Ltd.
All rights reserved.
Silecchia V, Valerio E, Filippone M, Balao L, Cherubin E, Rigon
L, Grimalt R, Cutrone M. Phakomatosis Pigmentovascularis
Cesioflammea. Journal of Dermatological Research 2019; 4(2):
189-190 Available from: URL: http//www.ghrnet.org/index.php/jdr/
article/view/2736
Abbreviations
RICH: rapidly involuting congenital hemangioma; NICH: non-
involuting congenital hemangioma
PATIENT PRESENTATION
A term newborn from a normal pregnancy came to our attention at
1 month of life for the presence of an atrophic lesion in the nucal
region, clinically resembling an involuting hemangioma (Figure 1).
This hypothesis was also strengthened by dermoscopy, which showed
some residual ectasic capillaries (Figure 1, box).
The mother reported to have noticed posteriorly at the base of the
neck, soon after birth, the presence of an ovalar area of atrophic skin
lifted in folds.
No cutaneous markers suggestive of disraphism (ie, pits, fur,
lipomas) were present. Therefore, our working diagnosis was that of
an in utero rapidly involuting congenital hemangioma (RICH).
Given the absence of associated symptoms, we decided not to
perform biopsy and opted for clinical follow up.
1 Department of Woman and Child Health, University of Padua,
Padova, Italy;
2 Neonatal Intensive Care Unit, “Pietro Cosma” Hospital,
Camposampiero (Padova), Italy;
3 Pediatric Dermatology Unit, “Dell’Angelo” Hospital, Mestre
(Venezia), Italy;
4 Universitat Internacional de Catalunya. Dermatology, Sant Cugat
del Vallès. Barcelona, Spain.
Confict-of-interest statement: The author(s) declare(s) that there
is no confict of interest regarding the publication of this paper.
Open-Access: This article is an open-access article which was
selected by an in-house editor and fully peer-reviewed by external
reviewers. It is distributed in accordance with the Creative Com-
mons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-
commercially, and license their derivative works on diferent terms,
provided the original work is properly cited and the use is non-
commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Enrico Valerio, Pediatric Intensive Care Unit,
Ospedale San Bortolo, Vicenza, Italy.
Email: enrico.valerio.md@gmail.com
Telephone: +39 0444 75 2887
Fax: +39 0444 75 2796
Received: July 30, 2019
Revised: August 6, 2019
Accepted: September 1, 2019
Published online: December 19, 2019
ABSTRACT
A term newborn was evaluated for the presence of a lesion
resembling an involuting hemangioma; dermoscopy showed some
residual ectasic capillaries, consistent with the diagnosis. At 5
months, lesion appeared in further light regression, comparable
to that of a classical capillary hemangioma at 2 years of life.
Pediatric hemangiomas are classified into infantile and congenital
hemangioma. Infantile hemangiomas typically are very pale at
TOPIC HIGHLIGHT
RICH (Rapidly Involuting Congenital Hemangioma) with Fetal
Involution
Valeria Silecchia
1
, Silvia Palatron
2
, Enrico Valerio
2
, Francesca Favot
3
, Ilaria Mattei
3
, Ramon Grimalt
4
, Mario Cu-
trone
3
189
J. of Dermatological Res. 2019 December; 4(2): 189-190
ISSN 2413-8223
Online Submissions: http://www.ghrnet.org/index./jdr/
doi:10.17554/j.issn.2413-8223.2019.04.46-10
Journal of Respiratory Research