Search
hemangioma (strawberry nevus)
Epidemiology:
- most common tumors of infancy
- occur in ~10/% of all births
Pathology:
- benign vascular lesions enlarge by hyperplasia of endothelial cells & attendant pericytes
- spontaneously involution leaves loose fibrofatty tissue
Genetics:
- juvenile hemangioam associated with defects in FLT4
Clinical manifestations:
- lesions typically appear a few months after birth [6]
- lesions enlarge rapidly during the first year of life
- spontaneously involution over a period of years
Complications:
1) hypopigmentation
2) skin atrophy
Management:
1) complete resolution in 1 year common (42-44%)
2) pulsed laser treatment NO better than observation
3) topical imiquimod may be of benefit for superficial hemangiomas [2]
4) oral propranolol 3 mg/kg/day for 6 months is safe & effective [3]
- propranolol resistance is rare [4]
Interactions
disease interactions
Specific
cavernous hemangioma (cavernoma, capillary venous lymphatic malformation, CVL, nevus cavernosus, vascular erectile tumor)
cutaneous hemangioma
epithelioid hemangioma; angiolymphoid hyperplasia with eosinophilia
hepatic hemangioma
venous lake
General
benign neoplasm
vascular tissue neoplasm; angioma
References
- Journal Watch 22(19):151, 2002
Batta K et al,
Randomized controlled study of early pulsed dye laser treatment
of uncomplicated haemangiomas: results of a 1 year analysis.
PMID: 12241656
Lancet 360:521, 2002
Hobenleutner U & Lanthaler M, Lancet 360:502, 2002
- Ho NTC et al
Topical imiquimod in the treatment of infantile hemangiomas:
A retrospective study.
J Am Acad Dermatol 2007, 56:63
PMID: 17190622
- Leaute-Labreze C, Hoeger P, Mazereeuw-Hautier J et al
A Randomized, Controlled Trial of Oral Propranolol in
Infantile Hemangioma.
N Engl J Med. 2015 Feb 19;372(8):735-746.
PMID: 25693013
http://www.nejm.org/doi/full/10.1056/NEJMoa1404710
- Causse S et al.
Propranolol-resistant infantile haemangiomas.
Br J Dermatol 2013 Jul; 169:125.
PMID: 23659587
- Agency for Healthcare Research and Quality (AHRQ)
Research Review - Final - Jan. 15m 2016
Diagnosis and Management of Infantile Hemangioma
http://www.effectivehealthcare.ahrq.gov/ehc/products/593/2170/infantile-hemangioma-report-160115.pdf
- Craig LM, Alster TS.
Vascular skin lesions in children: a review of laser
surgical and medical treatments.
Dermatol Surg 2013 Aug; 39:1137
PMID: 23379675