A 4-day-old infant presented for an initial well-child visit. His mother was concerned about discoloration on the right side of the infant's face. The discoloration was present at birth and had not changed in color or size. The mother reported that the infant showed no signs of bleeding, pruritus, or pain. He had no other lesions on his body.

The patient was born at full term by spontaneous vaginal delivery following an uncomplicated pregnancy and delivery. His birth weight was 3.19 kg (7 lb). The results of his newborn screening were pending at the time of the clinic visit, but his hearing test findings were normal. The family had no history of similar facial discoloration.

Physical examination revealed a flat, blanchable facial lesion that was purple-red. It was located on the right side of the infant's face with a temporomandibular distribution that included the right ear (Figure 1). No other dysmorphic features were apparent.

Question

Based on the patient's history and physical examination, which one of the following is the most likely diagnosis?

• A. Cavernous hemangioma (deep hemangioma).

• B. Cephalohematoma.

• C. Child abuse.

• D. Nevus flammeus (port-wine stain).

• E. Nevus simplex (macular stain).