# Completely ulcerated infantile hemangioma: a diagnostic challenge

## TL;DR

A 5-month-old infant with a completely ulcerated hemangioma was initially misdiagnosed, but propranolol treatment led to full recovery.

## Contribution

Highlights the diagnostic difficulty of ulcerated infantile hemangioma and its successful treatment with propranolol.

## Key findings

- UIH was misdiagnosed as pyoderma gangrenosum or mycobacterial infection.
- Propranolol treatment healed the ulcer within 3 weeks and prevented relapse.
- GLUT-1 immunohistochemistry confirmed the diagnosis of UIH.

## Abstract

The present case report describes a completely ulcerated infantile hemangioma (UIH) in a 5-month-old infant on the left proximolateral thigh initially misdiagnosed as pyoderma gangrenosum, sporotrichosis or atypical mycobacterial infection. Clinical assessment, histological findings, and GLUT‑1 immunohistochemistry confirmed the diagnosis of UIH. Systemic propranolol treatment led to rapid ulcer healing within 3 weeks and complete recovery without relapse after 18 months of treatment. The report emphasizes the diagnostic challenges, effective propranolol treatment and the importance of considering UIH in the differential diagnoses of solitary pediatric ulcers.