DEAR EDITOR, A female newborn was hospitalized because of a red–purple mass on the abdomen (a) and severe thrombocytopenia (5 9 10 cells L ). Histologically, a multilobular vascular proliferation was seen, composed of infiltrating nodules of spindle endothelial cells, with peripheral dilated lymphatic vessels. The spindle cells formed short fascicles and lined slit-like spaces (b, c; haematoxylin and eosin, original magnification 9 100 and 9 200). A diagnosis of kaposiform haemangioendothelioma (KHE) with Kasabach–Merritt phenomenon (KMP) was made. The patient was otherwise healthy. KHE is a rare vascular tumour. The prognosis depends on both tumour infiltration and KMP. Treatment with vincristine 0 05 mg kg 1 was conducted for 19 weeks, and residual tumour was excised. After 1 year the child is free of disease. E . MOSCAR E L L A O. AMETRANO M. D I P LOMAT I CO C . DE CH IARA M. CAPA S SO M.E . ERR I CO R. P I C C IOCCH I 2 Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy Pediatric Dermatology Unit, Neonatology Unit, Oncology Unit and Pathology Unit, AORN Santobono Pausilipon, Naples, Italy Pediatric Unit, Second University of Naples, Naples, Italy E-mail: elvira.moscarella@gmail.com

Conflicts of interest: none declared. http://orcid.org/0000‐0001‐7798‐4368 Dear Editor, A 4‐month‐old girl presented with a perineal infantile haemangioma.1 It appeared during the second week of life, associated with a large skin tag and two cutaneous orifices in the anogenital and sacral areas (a, b). These were connected through a complex horseshoe fistula detected by fistulogram (c). Spinal magnetic resonance investigation showed a lipomyelomeningocele producing a tethered cord (e). The patient was otherwise normal in terms of development, so on the basis of the clinical and radiological findings a diagnosis of PELVIS syndrome was made. PELVIS is an acronym indicating the association of perineal haemangioma, external genitalia malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus and skin tag.2 Because of the small size of the infantile haemangioma, the patient was given propranolol 1% cream twice daily, with good response after 3 months (d).