Infantile hemangioma. Part 2: Management

Sebaratnam, Deshan F; Bandera, Ana Isabel Rodríguez; Wong, Li‐Chuen; Wargon, Orli

doi:10.1016/j.jaad.2021.08.020

Cited by 72 publications

(86 citation statements)

References 110 publications

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“…12 Interferon and vincristine are no longer recommended. 14 All systemic medications have a wide range of adverse effects that must be closely monitored during treatment. 4 However, the majority of IHs do not meet the requirements for treatment.…”

Section: Case Discussionmentioning

confidence: 99%

Benign Neonatal Hemangiomatosis

Miller

Gordon

Peterson

et al. 2022

Advances in Neonatal Care

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Background: Benign neonatal hemangiomatosis (BNH) is a rare, self-limiting subtype of infantile hemangiomas (IHs), in which infants with multiple cutaneous hemangiomas lack visceral involvement. Other subtypes of IHs exist that may mimic BNH and can be life-threatening depending on hemangioma location and size. Clinical Findings: At birth, a 295/7-week preterm female presented with several pinhead-sized pink papules distributed throughout her body. At 10 days of age, the patient had 12 enlarged domed-shaped red papules in a generalized distribution throughout her body. Over several weeks, the number and size of the domed-shaped red papules continued to increase to a total of 26 located on the head, chest, abdomen, back, legs and arms. They were of firm consistency with both smooth and lobulated surfaces. Primary Diagnosis: A diagnosis of BNH was made after extensive workup did not reveal any extracutaneous hemangiomas. Interventions: Due to the lack of extracutaneous involvement and low-risk location/size of hemangiomas in our patient, no interventions were pursued and an observation-only approach was implemented. Outcomes: The patient remained stable while followed up over 8 months, with the size of the hemangiomas only increasing slightly in proportion to the patient's natural body growth. Practice Recommendations: Given the life-threatening nature of certain hemangioma subtypes, it is important to implement a proper workup and subtype diagnosis as early as possible in any infant with multiple hemangiomas.

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Section: Case Discussionmentioning

confidence: 99%

Benign Neonatal Hemangiomatosis

Miller

Gordon

Peterson

et al. 2022

Advances in Neonatal Care

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“…The high-risk areas are the head and neck, the axilla, and the anogenital region [1,9]. Disfigurement usually applies to residual lesions after natural involution or treatment and may present as fibrofatty tissue, anetoderma, scarring, telangiectasia, or deformations [10]. Obstruction and functional impairment are commonly associated with IHs located in the head and neck area and around natural orifices of the body [1,7].…”

Section: Complicationsmentioning

confidence: 99%

Infantile Hemangiomas: An Update on Pathogenesis and Treatment

Kowalska

Dębek

Matuszczak

2021

JCM

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Infantile hemangiomas are the most common benign vascular tumors in infancy. This review includes an update on the current knowledge on pathogenesis, a discussion on indications for treatment, and a review of the mechanisms underlying the different treatment methods. Although most infantile hemangiomas require only active observation because of their natural course, which results in involution, about 10% present with complications that require immediate treatment. The basic treatment includes systemic and topical options. In cases of insufficient response or rebound growth, other forms of treatment should be considered. In some cases, combined therapy might be initiated.

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“…1 Although not completely understood, the therapeutic efficacy of propranolol is probably due to a mix of actions that includes vasoconstriction, decreased expression of angiogenic factors, mainly VEGF, and apoptosis of capillary endothelial cells. 15 IHs are the most common pediatric vascular tumors, which start within the first few months of life, show a phase of endothelial cell proliferation that lasts on 6-18 months and slowly involutes. 16 Little is known about the pathogenesis of IHs, but local hypoxia is considered as a stimulus triggering vascular proliferation, which would represent a homeostatic response of the hypoxic tissue to the increased production of cytokines such as VEGF; however, this possibility is presently debated.…”

Section: Role Of β2-armentioning

confidence: 99%

“…The demonstration that propranolol, a nonselective β‐AR antagonist, blocking both β1‐ and β2‐ARs, induces the regression of a significant percentage of IHs 14 derives from the original observation that propranolol, administered for the cardiac implication to an infant suffering from IH, serendipitously leads to the regression of the hemangioma 1 . Although not completely understood, the therapeutic efficacy of propranolol is probably due to a mix of actions that includes vasoconstriction, decreased expression of angiogenic factors, mainly VEGF, and apoptosis of capillary endothelial cells 15 …”

Section: The First Step: From Ih To Ropmentioning

confidence: 99%

β3‐Adrenoceptor, a novel player in the round‐trip from neonatal diseases to cancer: Suggestive clues from embryo

Filippi

Pini

Cammalleri

et al. 2021

Medicinal Research Reviews

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The role of the β-adrenoceptors (β-ARs) in hypoxia-driven diseases has gained visibility after the demonstration that propranolol promotes the regression of infantile hemangiomas and ameliorates the signs of retinopathy of prematurity (ROP). Besides the role of β2-ARs, preclinical studies in ROP have also revealed that β3-ARs are upregulated by hypoxia and that they are possibly involved in retinal angiogenesis. In a sort of figurative round trip, peculiarities typical of ROP, where hypoxia drives retinal neovascularization, have been then translated to cancer, a disease equally characterized by hypoxia-driven angiogenesis. In this step, investigating the role of β3-ARs has taken advantage of the assumption that cancer growth uses a set of strategies in common with embryo development. The possibility that hypoxic induction of β3-ARs may represent one of the mechanisms through which primarily embryo (and then cancer, as an astute imitator) adapts to grow in an otherwise hostile environment, has grown evidence. In both cancer and embryo, β3-ARs exert

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Infantile hemangioma. Part 2: Management

Cited by 72 publications

References 110 publications

Benign Neonatal Hemangiomatosis

Benign Neonatal Hemangiomatosis

Infantile Hemangiomas: An Update on Pathogenesis and Treatment

β3‐Adrenoceptor, a novel player in the round‐trip from neonatal diseases to cancer: Suggestive clues from embryo

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