“…The HSS assigns higher scores to previously established high‐risk characteristics such as size, location, association with other structural anomalies, hemangioma complications (including visual compromise and ulceration), pain, and likelihood of permanent disfigurement . Janmohamed et al recently described a scoring system, the Hemangioma Activity Score (HAS), to measure proliferative activity based on the color of the IH, and the HAS has recently been shown to have advantages over the HSS in measuring longitudinal response to therapy , but the instrument design places an emphasis on activity rather than severity. In many cases, the two scoring systems correlate, but there are some situations in which a highly proliferative hemangioma may not be severe enough to warrant therapy, such as a small active lesion on the trunk, and the HAS does not account for severity associated with potential syndromic associations.…”