These are rare vascular tumors which, in contrast to the classic infantile hemangioma, are already present and fully developed at birth. They do not proliferate after birth. Based on their further development, they are subdivided into rapidly involuting congenital hemangiomas (RICH), non-involuting congenital hemangiomas (NICH) and partially involuting congenital hemangiomas (PICH). In contrast to the raspberry red of infantile hemangioma, these are clinically more bluish-reddish in color and more blurred in demarcation; they often show a pale rim.
Histopathological examination, which is sometimes indicated to exclude other vascular tumors, reveals lobular capillaries separated by connective tissue and often accompanied by atrophy of the skin appendages. The capillaries sometimes contain plump endothelial cells and pericytes, which may look very similar to the proliferative phase of an infantile hemangioma. However, the proliferation rate is very low in this case. In addition, congenital hemangiomas, unlike infantile hemangiomas, are negative for the glucose transporter GLUT1.