Initial work-up

• Detailed history of exact age of onset of lesion and any changes.

Recommended pre-referral treatment

• For haemangiomas: reassurance unless problems expected
• Parent/GP guidelines on  Infantile haemagioma   

When to refer

• URGENT Referralif a child has a several centimetre flat red facial mark that was not present at birth but appeared a few days later:  
• Please state whether the lesion was present at birth PLUS whether it is changing PLUS how large it is now. Without this information, we cannot appropriately triage your referral.
• A good quality colour photograph of the birthmark should be provided with the referral. This greatly assists us to have lesions seen promptly and by the right doctors.     

Exclusion criteria

• Simple haemangiomas unlikely to cause problems
• Giant congenital melanocytic nevi (pigmented, 'bathing trunk') should be referred to Dr David Orchard, Dermatology, RCH and/or Plastic Surgery, RCH.

Resources

• Make a referral:Specialist Clinics
• Contacts
• RCH Primary Care Liaison (GP website)
• Kids Health Info (Parent information website)  

References and more reading

• Paediatric Handbook (2009). Eighth Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia.

Guideline developed by specialists at the RCH. First published Jan 2008. Reviewed August 2009. Please read  Copyright and Disclaimer