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PHACE syndrome is a spectrum disorder involving posterior fossa abnormalities, haemangiomas, arterial lesions, cardiac abnormalities and eye abnormalities.1 A female infant was born in good condition at 37 weeks’ gestation with an antenatal diagnosis of posterior fossa abnormality following the routine antenatal ultrasound screening programme, and subsequently confirmed on MRI (see figure 1). On day 2 of life, her parents noticed prominent small vessels on the right side of her face which had not been present at initial examination (see figure 2). Over the next 48 hours, the area became more red in colour and dermatology review of images raised the possibility of PHACE syndrome with a differential of Sturge-Weber syndrome. The infant had an echocardiogram which showed a 2 mm apical ventricular septal defect. A clinical genetics review within the first week gave a likely diagnosis of PHACE syndrome, which was later confirmed clinically. The haemangioma became more prominent over the first month of life and was successfully treated with low-dose propranolol due to the possibility of arterial lesions in this condition. The patient is otherwise well with no other associated abnormalities found on screening.