Location of infantile hemangioma is a predictor of volumetric sequelae after involution

Abstract

Although infantile hemangiomas (IH) spontaneously involute, some leave more volumetric sequelae than others. Identifying predictors of such sequelae would provide a management reference for IH lesions and help achieve favorable outcomes. Our objective is to explore the correlation between volumetric residue remaining after IH involution and its location and to identify other potential outcome predictors. All IH patients examined at our hospital from 2008 to 2011 were reviewed, and both the degree of volumetric residue after involution and the quantified degree of sequelae were obtained by comparing follow‐up photographs with photographs of lesions at their maximum size. We discovered that for children with a defined age at the initial visit, lesions of the perifacial area achieved significantly more volumetric regression than lesions of the central facial (P < 0.0001) and chest areas (P = 0.0002). Perifacial lesions had a significantly higher aesthetic score than those on the central facial area (P < 0.0001), chest (P < 0.0001) and trunk/extremities (P = 0.0226) when the age at initial visit and lesion type were consistent. Our study reveals that lesion location and age at initial visit are contributing factors to volumetric sequelae and the aesthetics of the lesion after involution. The results of this study provide a reference to guide treatment decisions with the aim of achieving a favorable outcome.

Aesthetic outcome of intralesional injection of lauromacrogol as a single‐agent treatment for uncomplicated infantile hemangiomas: A long‐term follow‐up study

“…Previous studies reported that more than half of untreated IH left residual lesions after regression; and the most common sequelae were telangiectasia, fibrofatty residue and scars 2,3 . Moreover, IH in the central facial region, including the eyelids, nose and lips, had a higher risk of permanent sequelae after regression 17 …”

Predictors of treatment responses of superficial infantile hemangiomas to topical timolol

“…After 8 months of treatment, the lesion thickness was 1.5 mm (regression rate = 21.1%). In the vast majority of researchs on IHs, the regression rate was traditionally defined by subjective outcome evaluations, such as a VAS 19,20 or GAS, 10 based on the improvement of the most important characteristics of IHs (thickness and/or color of superficial IHs, 10,19,20 and volume of deep or mixed IHs 7,21 ). To improve accuracy and credibility, Bingham 22 Although color is also an important characteristic of IH, the therapeutic regimen for IH is largely not determined based on color.…”

Does Oral Propranolol Improve the Final Outcome of All Involuted Infantile Hemangiomas? A Matched Retrospective Comparative Study

“…To assess whether the overall effect of oral propranolol treatment for IHs could commensurate that of spontaneous involution, we designed a matched comparative study to eliminate 2 known confounding factors [1][2][3] and investigate the long-term outcome of these propranololtreated and untreated lesions. To avoid selection bias while maintaining comparability, the cases were paired according to their original documented pictures, without knowing their prognosis.…”

“…We selected from patient cohorts of those who received oral propranolol therapy for their IH and those who adopted the wait-and-see method. Patients from the oral propranolol cohort were individually matched with a patient from the untreated cohort, whose lesion has a similar location and morphology, which have both been considered risk factors for leaving sequelae 1,2 . The remaining patients of the oral propranolol therapy cohort whom we were unable to pair with an untreated patient were omitted from this study.…”

“…They have a spontaneous and gradual involution course but often leave different types and degrees of sequelae that can cause disfigurement and severely influence patients' aesthetic appearances 1 . Researches reveal that lesions on certain parts of the face are at higher risk of sequelae and should be treated at an early stage 2,3 . Oral propranolol has been used as the first-line therapy for such troublesome IHs 4 ; however, comparative studies on the extent of its effect are lacking.…”