Key Action Statement 1A: Clinicians should classify an IH as high risk if there is evidence of or potential for the following: (1) life-threatening complications, (2) functional impairment or ulceration, (3) structural anomalies (eg, in PHACE syndrome or LUMBAR syndrome), or (4) permanent disfigurement (grade X, strong recommendation).

Aggregate Evidence QualityGrade X
BenefitsEarly recognition of high-risk, potentially problematic IHs facilitates early specialist evaluation and management and potential avoidance of complications
Risks, harm, costUnnecessary parental concern regarding lesions inappropriately characterized as high-risk IHs
Benefit-harm assessmentThe benefits of identifying high-risk IHs outweigh the harm
Intentional vaguenessNone
Role of patient preferenceNone
ExclusionsVascular lesions that are not true IHs
StrengthStrong recommendation
Key references523