Verrucous Hemangioma Leg: A Challenging Birthmark

The document reports on a case of a 6-month-old boy with verrucous hemangioma (VH), a rare congenital vascular malformation characterized by reactive acanthosis, papillomatosis, and hyperkeratosis, typically located on the lower limbs. The boy was referred with a congenital asymptomatic black-blue birthmark on his left medial thigh and shin, which was diagnosed as VH based on its appearance at birth, location, and color. Dermatoscopy revealed specific vascular patterns, and ultrasound confirmed the lesion extended into the subcutaneous tissue. Surgery is the primary treatment for VH, but the timing and extent of surgical intervention can be challenging, as in this case due to the size and depth of the lesions. The document emphasizes the importance of recognizing VH and the potential for novel dermatoscopic findings to aid in diagnosis.