clinical features
Last reviewed 07/2022
Infantile haemangiomas can occur anywhere in the body. Most frequent sites include (1):
- head and neck - 60%
- trunk - 25%
- limbs -15%
The majority of haemangiomas appear around 2 weeks after birth. About one-third are noticed at birth manifesting as an erythematous macular patch, a blanched area, telangiectasia, or a pseudoecchymotic stain (1)
- life span of infantile haemangiomas can be divided into (1):
- rapid proliferative phase (0-1 year)
- slow involuting phase (1-7 years)
- involuted phase (8-12 years)
- infantile haemangiomas are classified into superficial, deep, or combined
forms
- superficial infantile haemangiomas (include the "strawberry naevus type") appear red, raised, and lobulated, whereas deep lesions have normal overlying skin and appear as raised soft masses, often with a bluish cast (2)
- morphologic subtypes of infantile haemangiomas include localized and
segmental forms (3)
- haemangiomas that have regressed may sometimes leave behind fibrofatty depositions, overlying anetoderma, and telangiectasia (4)
- ulcerations, bleeding, airway involvement, and vision impairment are some of the complications of haemangiomas
- visceral haemangiomas are more likely in a child who has multiple cutaneous lesions (>5). Most of them are seen on the liver. Other sites include the lungs, brain, and intestines (2)
- large facial infantile haemangiomas have higher rates of complications than small localised haemangiomas and can be associated with neurological, ophthalmologic, and cardiac anomalies - PHACE syndrome (3)
- glucose transporter-1 (GLUT-1) is strongly expressed by the cells of infantile haemangioma (1)
Reference:
- 1. Mulliken JB et al. Case 13-2004. A newborn girl with a large cutaneous lesion, thrombocytopenia, and anemia. N Engl J Med. 2004;350(17):1764-75.
- 2. Spring S et al. Dermacase: infantile hemangioma. CFP 2009;55(4):380-381
- 3. Haggstrom AN et al. Patterns of infantile hemangiomas: new clues to hemangioma pathogenesis and embryonic facial development. Pediatrics 2006;117:698-703
- 4. Garzon MC et al. Vascular malformations: Part I. J Am Acad Dermatol. 2007;56(3):353-70