Atypical development and swift resolution of an ulcerated hemangioma: a case report

BACKGROUND: Infantile hemangiomas are considered as the most common benign vascular tumors in pediatric patients. Ulceration is one of the most frequent complications that typically occur at 2-3 months after birth. CASE PRESENTATION: A Caucasian Georgian male infant started to develop a hemangioma at 5 days old. At 3 weeks old, a pediatrician diagnosed it, and the patient was referred to a dermatologist. A week after starting initial treatment, at 4 weeks of age, the hemangioma ulcerated. Despite changing the initial treatment, the ulceration worsened. At 6 weeks old, topical timolol and mupirocin were initiated, leading to complete healing within 4 weeks. Timolol is still being applied, and follow-up visits showed no further ulceration. CONCLUSION: Although the exact cause of the unusual ulcer development is unknown, we advise physicians to avoid prescribing topical ointments that have not been proven effective and safe for treating hemangioma.