A 2-month-old girl presents to the pediatric outpatient clinic with a small mass inferior to her right medial canthus (Fig 1). The area was noted to be slightly raised at birth but has become more apparent following an episode of coldlike symptoms at 1 month of age. The lesion increases in size, develops a bluish hue, and becomes more prominent with crying. There is no fever, eyelid edema, ocular discharge, conjunctival injection, or respiratory distress. The infant has prominent veins on her right upper eyelid that are unchanged since birth. The patient was born at 39 weeks’ and 2 days’ gestation via vaginal delivery to a 33-year-old woman with a history of bipolar disorder. The pregnancy was complicated by tobacco and marijuana use. Prenatal medications included a multivitamin, cyclobenzaprine, promethazine, famotidine, loratadine, and hydroxyzine. The infant is growing and developing well. There is no significant family history.

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