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Qiu T, Yang K, Dai S, Chen S, Ji Y. Clinical Features of Segmental Infantile Hemangioma: A Prospective Study. Ther Clin Risk Manag 2021; 17:119-125. [PMID: 33536759 PMCID: PMC7850443 DOI: 10.2147/tcrm.s291059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/11/2021] [Indexed: 02/05/2023] Open
Abstract
Background Infantile hemangioma (IH) is the most common benign tumor in children. However, few studies have reported the clinical features of segmental IH. We aimed to determine the clinical characteristics of segmental IH and to identify features that may aid clinicians in managing segmental IH. Methods In the cross-sectional prospective study approved by the Ethics Committee of the hospital, children diagnosed with IH were recruited, and information including patient demographics, IH morphology and anatomical location, complications and treatments were recorded and analyzed. Results In total, 153 patients with segmental IH and 1375 patients with nonsegmental IH were enrolled in this study. The average age on the day of the first visit in patients with segmental IH was 3.63±3.23 months. In 69 patients (45.10%), segmental IH was diagnosed at birth. Most segmental IHs (49.67%) occurred in the limbs, while only 22.04% of nonsegmental IHs occurred in the extremities (P<0.001). Thirteen patients (8.50%) with segmental IH had ulceration. Compared with patients with nonsegmental IHs, patients with segmental IHs were more likely to be treated with oral drugs (P<0.001). Conclusion Segmental IHs mainly occur in the extremities and are frequently diagnosed at birth. Segmental IHs are usually accompanied by ulceration, which are more commonly seen in the neck and perineal/perianal/genital areas than nonsegmental IHs. Oral propranolol is prescribed more often in patients with segmental IH than in those with nonsegmental IH.
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Affiliation(s)
- Tong Qiu
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Kaiying Yang
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Shiyi Dai
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Siyuan Chen
- Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Yi Ji
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
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Welfringer-Morin A, Fraitag S, Balguerie X, Laaengh-Massoni C, Leclerc-Mercier S, Hadj-Rabia S, Bodemer C, Boccara O. Late ulceration of residual abortive infantile haemangioma: a rare complication. Br J Dermatol 2019; 181:395-396. [PMID: 30719710 DOI: 10.1111/bjd.17717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Welfringer-Morin
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Universitaire Necker - Enfants Malades, APHP, Paris, France
| | - S Fraitag
- Department of Pathology, Hôpital Necker - Enfants Malades, Université Paris Descartes- Sorbonne Paris Cité, Paris, France
| | - X Balguerie
- Department of Dermatology, CHU de Rouen, Rouen, France
| | - C Laaengh-Massoni
- Centre D'Explorations Vasculaires, 7 rue Chalgrin, 75116, Paris, France
| | - S Leclerc-Mercier
- Department of Pathology, Hôpital Necker - Enfants Malades, Université Paris Descartes- Sorbonne Paris Cité, Paris, France
| | - S Hadj-Rabia
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Universitaire Necker - Enfants Malades, APHP, Paris, France
| | - C Bodemer
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Universitaire Necker - Enfants Malades, APHP, Paris, France
| | - O Boccara
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Universitaire Necker - Enfants Malades, APHP, Paris, France
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[Rare presentations of infantile hemangiomas: 4 cases]. Ann Dermatol Venereol 2018; 145:749-755. [PMID: 30415930 DOI: 10.1016/j.annder.2018.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/04/2018] [Accepted: 07/31/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Infantile hemangioma (IH) is a common benign vascular tumor in children. In most cases, diagnosis is based entirely on clinical examination. When the diagnosis is uncertain, the first-line complementary examination is Doppler ultrasound. We report 4 cases of atypical infantile hemangiomas with delayed diagnosis and non-contributory imaging. PATIENTS AND METHODS One child had congenital purple papules and nodules on the back of the foot, the second had inaugural ulceration of the buttocks, and the last two presented telangiectasia, either isolated or on an erythematous macula. In two cases, ultrasound showed no vascular lesions, and in the other two cases, the absence of hyperemia did not allow a diagnosis of IH to be made. For one patient, diagnosis was made on the basis of cutaneous biopsy, and for the other three, on the basis of clinical course. DISCUSSION We report 4 rare forms of infantile hemangioma resulting in initial diagnostic error. The atypical nature of some IHs may direct the clinician and the radiologist toward other diagnoses that in some cases have no vascular contingent. It is important for the dermatologist to be aware of these rare forms of IH in order to reduce the time to diagnosis and allow early initiation of appropriate management.
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Wang JY, Ighani A, Ayala AP, Akita S, Lara-Corrales I, Alavi A. Medical, Surgical, and Wound Care Management of Ulcerated Infantile Hemangiomas: A Systematic Review [Formula: see text]. J Cutan Med Surg 2018; 22:495-504. [PMID: 29673261 DOI: 10.1177/1203475418770570] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Ulcerated infantile hemangiomas may present a therapeutic challenge, especially if there is concurrent hemorrhage or infection. The aim of this study was to systematically review the published evidence on the treatment of ulcerated hemangiomas, focusing on wound healing as the outcome of interest. We searched MEDLINE, Embase, SCOPUS, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science from inception to July 2016. Seventy-seven studies met our inclusion criteria. One study was a randomized controlled trial, 30 were observational studies, and 46 were case reports or case series. There is significant heterogeneity among the methods used. We reviewed 1239 patients in total. Of the 197 treated with oral propranolol, 191 (97.0%) achieved complete ulcer healing. Thirty-one patients failed corticosteroid therapy (oral, intralesional, or topical) and were subsequently successfully treated with other therapies. Surgical resections were typically performed for larger hemangiomas and those causing complications. None of the therapies discussed appear to offer significant advantages over others. Therefore, treatment decisions should be individualized based on location of disease, extent, symptoms, feasibility, cost, and parental preference.
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Affiliation(s)
- Jane Y Wang
- 1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Arvin Ighani
- 1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ana P Ayala
- 2 Gerstein Science Information Centre, University of Toronto, Toronto, ON, Canada
| | - Sadanori Akita
- 3 Department of Plastic Surgery, Wound Repair and Regeneration, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Irene Lara-Corrales
- 4 Department of Pediatric Medicine, Section of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Afsaneh Alavi
- 5 Division of Dermatology, Women's College Hospital, University of Toronto, Toronto, ON, Canada
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Calderón-Castrat X, Peceros-Escalante J, Velásquez F, Lipa-Chancolla R, Ballona R. Segmental Infantile Hemangioma With Minimal or Arrested Growth in LUMBAR Syndrome. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Calderón-Castrat X, Peceros-Escalante J, Velásquez F, Lipa-Chancolla RM, Ballona R. Segmental Infantile Hemangioma With Minimal or Arrested Growth in LUMBAR Syndrome. ACTAS DERMO-SIFILIOGRAFICAS 2016; 108:475-477. [PMID: 27939875 DOI: 10.1016/j.ad.2016.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/01/2016] [Accepted: 10/05/2016] [Indexed: 01/25/2023] Open
Affiliation(s)
- X Calderón-Castrat
- Servicio de Dermatología, Hospital Universitario de Salamanca, Salamanca, España.
| | - J Peceros-Escalante
- Servicio de Dermatología, Instituto Nacional de Salud del Niño, Breña, Lima, Perú
| | - F Velásquez
- Servicio de Dermatología, Instituto Nacional de Salud del Niño, Breña, Lima, Perú
| | - R M Lipa-Chancolla
- Servicio de Anatomía Patológica, Instituto Nacional de Salud del Niño, San Borja, Lima, Perú
| | - R Ballona
- Servicio de Dermatología, Instituto Nacional de Salud del Niño, Breña, Lima, Perú
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Abstract
Infantile hemangiomas are the most common tumors of infancy. The serendipitous discovery of the therapeutic efficacy of propranolol in the management of infantile hemangiomas has revolutionized the care and understanding of these lesions, and greatly improved the prognosis for a good cosmetic outcome. In addition, there has been an expansion of indications for treatment of hemangiomas, taking into account not only those hemangiomas that can cause airway compromise, amblyopia, and cardiac overload, but also those lesions that can lead to unsatisfactory cosmetic outcome or deformity after involution. Current concepts of pathogenesis of infantile hemangiomas, of segmental hemangiomas with systemic associations, of hepatic hemangiomas, and of the use of systemic and topical beta-blockers for the management of IH are all reviewed.
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Affiliation(s)
- Kachiu C Lee
- Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI 02903, USA
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