Infantile Perianal Pyramidal Protrusion with Coexisting Perineal and Perianal Hemangiomas: A Fortuitous Association or Incomplete PELVIS Syndrome?
A 2-month-old female child was brought to the same clinic where she was examined by both authors (i.e., SV and UW). The child had a flattened erythematous leaf-like midline protrusion located anterior to the anus which had grown gradually []. She too was born after a normal full-term vaginal delivery and had no history of consanguinity in her parents. The parents had noticed the lesion only after 2 weeks of her birth. A hemangiomatous plaque to the left of the anus had been noticed by the parents as a pink-colored macule which had gradually deepened in color but had not grown in size. There was no surrounding inflammation. There were no other skin findings or any other structural or functional abnormalities detected. The parents refused a pediatric surgical reference for any further intervention. They called after 2 months saying that the hemangioma was flattening rapidly but the leaf-like protrusion remained unchanged. A diagnosis of IPPP was made for both the cases with the diagnosis of the first case done retrospectively. This opens up the strong possibility of the IPPP being a part of PELVIS syndrome in which a ‘skin tag’ is described with perineal hemangioma and other features.