Infantile hemangiomas (IHs) are the most common tumor of infancy and have been estimated to occur in 4% of infants. Only two previous incidence studies of IH in a healthy population have been published, and both of these were performed in the first week of life. The objective was to identify the incidence of IH in an Australian neonatal population and characterize the risk factors. All women who presented to the postnatal ward in a 200-bed maternity hospital were asked to complete a questionnaire. Details of maternal history and birth details were recorded. Two follow-up emails 3 and 6 weeks after discharge were sent to all mothers who consented, asking if their baby had developed an IH. Babies reported to have an IH were seen in clinic to confirm the diagnosis. Details were collected from 1,034 mothers of 1,065 babies; 28 (2.6%) of the infants developed IH. Babies that developed IH were more likely to be female (p < 0.001), have a low birth weight (p = 0.020), be born at a gestational age of <37 weeks (p = 0.005), and be conceived through in vitro fertilization (IVF) (p = 0.001) than those who did not. The incidence of IH at 6 weeks of life was 2.6%.

The mechanism of action of beta adrenergic blockers in the involution of infantile haemangioma (IH) remains unclear. It has been proposed that the renin-angiotensin pathway may play a role. We present a retrospective case series of 17 patients with IH who were treated with oral corticosteroid therapy and developed hypertension requiring treatment with the angiotensin converting enzyme inhibitor, captopril. All patients, with written documentation, demonstrated an improvement in their lesion at the start of oral corticosteroid therapy (n = 14). Captopril alone did not sustain the corticosteroid-induced involution with a documented worsening of infantile haemangioma in seven out of 12 patients (58%).

No abstract

We present a case of non-involuting congenital haemangioma (NICH) of the right eyelid which was present at birth as a purpuric macule but increased in size to cause significant obstruction of vision. At four years of age the lesion was treated with fluroscopic ultrasound-guided sclerotherapy using 0.5% sodium tetradecyl suphate foam and surgically debulked 16 days later. Histopathology was negative for glucose transporter-1 stain confirming the diagnosis. The residual segments were subsequently treated in three further sessions of sclerotherapy in the ensuing three years. This treatment approach resulted in a good cosmetic and functional outcome with no associated complications. To our knowledge, this is the first published case of a histologically confirmed NICH treated primarily with sclerotherapy.

Proliferative nodules (PN) are benign lesions that arise in large congenital melanocytic naevi (LCMN). Clinically and histologically they can be difficult to differentiate from malignancies, which are also associated with LCMN. The PN in this case consisted of undifferentiated spindle cells and exhibited unusual histological features including negative stains for melanocytic markers (S100, HMB45 and MelA), negative stain for c-Kit, high mitotic index and unusual morphology of the lesional cells. As a result, a firm histological classification could not be made, which posed a challenge for the clinical management.

No abstract