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misterdoctor69
The main thing that bothers me about this question is that if it is indeed nevus simplex, it's definitely a very non-typical presentation. Nevus simplex most commonly occurs on he back of the neck/midline locations plus they are pink in color.
The lesion described in this question is purplish (not pink) and it appears on the right side of the face (ie. neither back of neck nor midline). We can definitely rule out nevus flammeus because that is only seen in the setting of Sturge-Weber syndrome, which this patient has no signs of. We can also rule out strawberry hemangioma because such a lesion would be raised, not flat.
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osteopathnproud
To add to that, I guess in the NBME world you can not have a nevus flammeus if there is no Sturge-Weber syndrome, in the real world most nevus flammeus are not associated with Sturge-Weber syndrome, but if a patient has Sturge-Weber syndrome then he is very likely to have a nevus flammeus
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To me it sounds more like nevus simplex. The most common capillary malformation is nevus simplex, which affects more than half of infants. Nevus simplex, or “salmon patch,” lesions are pink, ill-defined patches that tend to occur in midline locations, most frequently on the nape of the neck, glabella, eyelids, nose/lips, scalp, and sacral region Historically, colloquial terms such as “stork bite” (nape) and “angel kiss” (forehead/glabella) referred to nevus simplex lesions in particular anatomical regions. Unlike PWS and most other vascular malformations, most nevus simplex lesions regress within the first 2 years of life Clinical differentiation of nevus simplex from PWS, especially on initial presentation, can be difficult. Lesions with lighter pink color, midline location, and indistinct borders favor nevus simplex. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615389/