skin vesicles to a large multilobular mass Clear lymph fluid can turn purple or red with intralesional bleeding Complications are related to interference with, or invasion of surrounding structures as mentioned in lateral neck lesions above Limb lymphatic malformations can lead to elephantiasis, usually later in life These lesions are also prone to recurrent cellulitis ED treatment should include pain management, evaluation for infection, and referral to a specialist FIGURE 120.15 Facial port-wine stain (Reprinted with permission from Weber J, Kelley J Health Assessment in Nursing 2nd ed Philadelphia, PA: Lippincott Williams & Wilkins; 2003.) Infantile Hemangiomas Infantile hemangiomas , the most common benign neoplasm of infancy, occur in more than 10% of children younger than year of age Histologically, they are composed of hyperplastic vascular endothelium that develops from angioblastic tissue that has failed to connect normally with the vascular system during gestation Although infantile hemangiomas are rarely evident at birth (2.5% of cases), most become apparent within the first month of life There is an increased incidence in Caucasian, female, and premature infants Sixty percent of all infantile hemangiomas are located in the head/neck region Lesions tend to undergo a period of rapid growth over the first to 12 months, then plateau Subsequently, a slow process of involution begins, usually by 18 months Approximately 50% of lesions involute completely by years of age, and 95% by