Distribution analysis of infantile hemangioma or capillary malformation on the head and face in Japanese patients

Abstract

Infantile hemangioma is one of the most common tumors in infancy. Delivery may be a clue for the trigger of infantile hemangioma formation in the head and face areas. In this study, we tried to plot localization of infantile hemangioma as well as capillary malformation on the head and face, and compared them to identify their characteristics and risk factors. The distribution of 104 lesions in 100 patients with infantile hemangioma was as follows: 32 lesions on the head, 12 on the forehead, 57 on the cheek and three in the jaw area. We could not find a statistically significant correlation of the distribution with three clinical subtypes (superficial, deep and mixed), sex or size of the lesions. However, the lesions in the jaw or chin areas were significantly less frequent than other areas (P = 0.0008 or 0.03, respectively). This tendency was not found in 40 patients with capillary malformation. Mechanical stress to jaw or chin areas may be less than other areas in normal cephalic delivery. Considering the emergence after birth and age‐dependent involution of infantile hemangioma, we speculate that physiological events including perinatal hypoxia or mechanical stress during delivery as the trigger of hemangioma formation. Taken together, our results may reveal the contribution of mechanical stress to the trigger of infantile hemangioma, not capillary malformation, and may facilitate clinical differentiation between the two diseases by their localization. Further studies with an increased number of patients will be necessary to validate the finding.

ISSVA Classification of Vascular Anomalies and Molecular Biology

“…This tendency was not found in 40 patients with capillary malformation. Mechanical stress to the jaw or chin areas may be lesser than in other areas in normal cephalic delivery, so these data may indicate the contribution of mechanical stress as a trigger of infantile hemangioma, not capillary malformation [35].…”

Prox1 Immunohistochemical Analysis of Pediatric Vascular Anomalies, a Posible Prognostic and Therapeutic Factor of Hemangiomas?

“…The highest number of cases of proliferating and involuting hemangiomas were excised from the head and neck region, and the involuted hemangioma is located predominantly on the trunk. Arterio-venous malformations were most frequently excised from the limbs, having the same location as the data in the literature [21].…”

APLN/APJ may act as a Novel Diagnostic Marker and a Potential Therapeutic Target for Infantile Hemangioma

“…Similar structures also occurred in CH and PG. In CH, there were obvious and irregular lobulated structures with brous tissue separation and central drainage vessels [1,6,13,14] (Figure 3 C); In PG, such structures easily protruded to the epidermis, and were surrounded by squamous epithelium on both sides, showing a "collar" like change [15][16][17] (Figure 3 D). In IH, ECs clusters were characterized by dense proliferation of ECs (Figure 3 G).…”