A new clinical and dermoscopic monitoring of infantile hemangiomas treated with oral propranolol

Abstract

Oral propranolol (OP) demonstrated high efficacy and safety profile for treatment of critical infantile hemangiomas (IHs). Our aim was to assess the morphologic changes of IHs with standard and high-resolution video dermoscopy (HRVD) from baseline to 18 months either in presence or absence of OP therapy; to investigate if extended anamnestic perinatal data and clinical-dermoscopic characteristics of the IHs can correlate with therapeutic outcome. We enrolled 94 patients (112 IHs): 58 were treated with OP, 35 (42 IHs) for 6 months (group 1), and 23 (25 IHs) for 12-months (group 2); 36 (45 IHs) were followed-up. Clinical-dermoscopic examinations were performed every 3 months during therapy and follow-up. Among 67 treated IHs, superficial and deep IHs with homogenous clinical-dermoscopic aspect developed after the 2 weeks of life achieved the better outcome, stable at 9-month follow-up, independently form treatment duration. Under HRVD, glomerular vessels were prevalent at baseline; corckscrew, comma, and linear-irregular vessels were the prevalent pattern at 1, 3, and 6 months of therapy, respectively. At 12-month follow-up, adequate healing was achieved by 96% of IHs in group 2 and by 78% in group 1, showing dotted vessels. Persistent IHs displayed a reticulated aspect and linear irregular vessels, while arborizing vessels characterized relapsed IHs. A 12-month OP therapy can be considered for newborns presenting with nonhomogenous mixed IHs >3 cm on the perineal area/ lower extremities. In conclusion, HRVD allows a real time monitoring of vascular changes in IHs treated with OP and can support physicians in identifying relapses before they become clinically evident.

Sequelae After Involution of Superficial Infantile Hemangioma: Early Intervention with 595-nm Pulsed Laser Combined with 755-nm Long-Pulsed Alexandrite Laser versus Wait-and-See

“…7,11 Studies have reported that more than half of untreated IH has not completely involution, and there residual Sequelae lesions in IH after involution. 8,9,12 These Sequelae lesions include telangiectasia, skin atrophy, excess skin, scars or fibrofatty tissue. This retrospective study showed that 39.5% of superficial IH in the observation group did not completely involution.…”

Non-Invasive Diagnosis of Angioma Serpiginosum Plantaris: High-Resolution Dermoscopy, High-Frequency Ultrasound, and Line-Field Confocal Optical Coherence Tomography

“…Recently, new non-invasive imaging devices that provide high-resolution skin images, such as high-resolution videodermoscopy (HRVD) [14][15][16], high-frequency ultrasound [15], and line-field confocal optical coherence tomography (LC-OCT) [15,[17][18][19], have been successfully employed in vascular skin lesions [14,15,17,18], orienting the diagnostic suspect in atypical/featureless cases.…”

Acroangiodermatitis with atypical presentation: Diagnostic imaging with high‐frequency ultrasound, high‐resolution dermoscopy and line‐field optical coherence tomography

“…[1][2][3][4] The histopathological examination is the gold standard for differential diagnosis with Kaposi sarcoma, [4][5][6] but non-invasive high-resolution imaging techniques are today available. [7][8][9][10] A 78-year-old patient presented for an ulcerative lesion on the right pre-tibial lesion occurred 10 days before in the context of a pigmented greyish area with clear-cut margins persistent since about 9 years, which appeared greyish to erythematous and soft at palpation; imprinted oedema was detectable in the distal portion (Figure 1c). The patient experienced a trauma at the right leg about 10 years before with followed by ulceration and erysipeloid infection.…”

“…The patient experienced a trauma at the right leg about 10 years before with followed by ulceration and erysipeloid infection. A noninvasive mapping combining high-resolution videodermoscopy (HRVD) 7 [HS600 Horus (Adamo S.r.l. )], 7 high-frequency ultrasound 8 (HFUS) 24-30 MHz [MyLab™X8 (Esaote)] and line-field confocal optical coherence tomography (LC-OCT) [Deeplive® (Damae)] 9,10 was realized at different lesional points (Figure 1, white circles).…”

“…A noninvasive mapping combining high-resolution videodermoscopy (HRVD) 7 [HS600 Horus (Adamo S.r.l. )], 7 high-frequency ultrasound 8 (HFUS) 24-30 MHz [MyLab™X8 (Esaote)] and line-field confocal optical coherence tomography (LC-OCT) [Deeplive® (Damae)] 9,10 was realized at different lesional points (Figure 1, white circles). HRVD showed unstructured whitish areas and streaks (Figure 1d,g) and a rainbow pattern (more evident in the distal leg areas; Figure 1g) in the context of a reddish to violaceous background.…”