Her hemangioma continued to grow rapidly, progressively obstructing the vision in her right eye, and at age 3 months she was started on oral corticosteroid therapy (prednisolone, 4 mg/kg daily, tapered to 4 mg/kg every other day, and then to 2 mg/kg every other day over 2 months). Her hemangioma initially appeared to improve, but ulceration developed at age 5 months (Figure 1), worsening despite an increase in the prednisolone dosage to 3.5 mg/kg daily. The hemangioma bled focally and oozed serosanguineous fluid, and the patient experienced increasing pain. Initially, wound cultures were negative for bacterial growth and home wound care consisted of bacitracin zinc-polymyxin B sulfate (Polysporin; Glaxo Wellcome Inc, Research Triangle Park, NC) and nonstick dressings that were changed every 3 days for approximately 6 weeks. Subsequently, dressings were changed to topical metronidazole gel and Mepilex Saftec (Mölnlycke Health Care, Götenborg, Sweden) dressings that were changed every other day.