A 3-month-old boy was referred for the evaluation of numerous reddish bumps all over the body, present since birth. Second-born of a non-consanguineous parentage, the baby was normally delivered and was otherwise healthy. Examination showed numerous bright red papules – some with erythematous base – distributed over the trunk, limbs, face, and genitalia (Fig. 1). Abdominal ultrasonography was normal. Histopathology of a biopsied specimen showed features of capillary hemangioma, and the child was diagnosed to have Benign neonatal hemangiomatosis (BNH).

Fig. 1 Numerous bright red papules of varying size over the trunk.

BNH denotes multiple cutaneous lesions without any symptomatic extracutaneous lesions or complications. When one or more extracutaneous organs are involved, the term diffuse neonatal hemangiomatosis is employed. The lesions of neonatal hemangiomatosis are small (2-20 mm) bright red papules. The differentials include bacillary angiomatosis (immunocompromised patient), dermal hematopoiesis (purple hue, setting of congenital infections or hemolytic anemia), leukemia cutis (reddish-brown to violaceous papules or nodules, and tend to localize to sites of trauma, surgery, or infections), or granuloma pyogenicum (collarette of scale at its base, and bleeds on minor trauma). Cutaneous hemangiomas tend to grow during infancy and regress during early childhood.