A 10-week-old female infant presented with a pinkish macule measuring 2mm in diameter on the medial area of the upper left eyelid that had first appeared a few weeks after birth (Fig. 1A). Physical examination did not reveal edema, proptosis, or abnormal ocular motility. Doppler ultrasound revealed a solid hypoechoic formation in the medial and superior extraconal adipose tissue that was compatible with infantile hemangioma in the proliferative phase. The lesion affected the medial border of the orbicularis muscle of the upper eyelid and projected towards the dermis (9.8mm in the transverse plane, 11.6mm in the anteroposterior plane, and 8.5mm in the longitudinal plane) (Fig. 1B). Color Doppler ultrasound revealed prominent internal vessels with median-to-low–velocity venous and arterial flows that reached the arterial vessels with a peak systolic flow of 37.6cm/s (Fig. 1C).

Figure 1

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Color Doppler ultrasound in infants with focal palpebral erythematous lesions could prove essential for the rapid, safe, and accurate detection of the nature, extension, and degree of vascularization in intraorbital vascular lesions. This in turn could prove critical for early initiation of treatment.