Multicenter Prospective Study of Ulcerated Hemangiomas

Chamlin, Sarah L.; Haggstrom, Anita N.; Drolet, Beth A.; Baselga, Eulàlia; Frieden, Ilona J.; Garzon, María C.; Horii, Kimberly A.; Lucky, Anne W.; Metry, Denise; Newell, Brandon; Nopper, Amy J.; Mancini, Anthony J.

doi:10.1016/j.jpeds.2007.04.055

Cited by 222 publications

(183 citation statements)

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“…6 Furthermore, some lesions are particularly aggressive or morbid and can cause severe pain, ulceration, and bleeding even in early stages. 7,8 Early assessment of the extent of the hemangioma, and early, appropriate treatment of IH may potentially mitigate these complications; however, in a large multicenter treatment analysis, the first specialist visit for infants and children did not occur until a mean age of 5 months. 5 The rapid growth of IH leaves little time for prospective observation to determine which IH will lead to complications and require specialist attention and treatment before complications begin to manifest.…”

Section: Discussionmentioning

confidence: 99%

Pharmacologic Interventions for Infantile Hemangioma: A Meta-analysis

Chinnadurai¹,

Fonnesbeck

Snyder

et al. 2016

Pediatrics

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STUDY SELECTION: Two reviewers assessed studies using predetermined inclusion criteria. DATA EXTRACTION:One reviewer extracted data with review by a second. RESULTS:We included 18 studies in a network meta-analysis assessing relative expected rates of IH clearance associated with β-blockers and steroids. Oral propranolol had the largest mean estimate of expected clearance (95%; 95% Bayesian credible interval [BCI]: 88%-99%) relative to oral corticosteroids (43%, 95% BCI: 21%-66%) and control (6%, 95% BCI: 1%-11%). Strength of evidence (SOE) was high for propranolol's effects on reducing lesion size compared with observation/placebo. Corticosteroids demonstrated moderate effectiveness at reducing size/volume (moderate SOE for improvement in IH). SOE was low for effects of topical timolol versus placebo. LIMITATIONS:Methodologic limitations of available evidence may compromise SOE. Validity of meta-analytic estimates relies on the assumption of exchangeability among studies, conditional on effects of the intervention. Results rely on assumed lack of reporting bias. CONCLUSIONS:Propranolol is effective at reducing IH size compared with placebo, observation, and other treatments including steroids in most studies. Corticosteroids demonstrate moderate effectiveness at reducing IH size/volume. The meta-analysis estimates provide a relative ranking of anticipated rates of lesion clearance among treatments. Families and clinicians making treatment decisions should also factor in elements such as lesion size, location, number, and type, and patient and family preferences. Dr Chinnadurai contributed to the conceptualization and design of the original review and meta-analysis and helped assess studies, verify data, develop the analysis, and draft the initial manuscript; Dr Fonnesbeck contributed to the conceptualization and design of the original review and meta-analysis, conducted the metaanalysis, and helped verify data and draft the initial manuscript; Drs Likis and McPheeters contributed to the conceptualization and design of the original review and meta-analysis and helped assess studies, develop the analysis, and draft the initial manuscript; Drs Morad and Snyder contributed to the conceptualization and design of the original review and meta-analysis and helped assess studies, verify data, develop the analysis, and draft the initial manuscript; Ms Sathe contributed to the conceptualization and design of the original review and meta-analysis and helped evaluate studies, extract and verify data, develop the analysis, and draft the initial manuscript; and all authors approved the fi nal manuscript as submitted. Infantile hemangiomas (IH) are the most common tumors of childhood. IH are benign but possess potential for permanent local tissue damage, ulceration, infection, bleeding, functional impact, and pain. Because of historical inconsistencies in naming conventions, the true prevalence of IH is unclear, but it is estimated that they affect ∼4% to 5% of children, 1 with higher prevalence in females and Caucasians. 2,3 ...

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Section: Discussionmentioning

confidence: 99%

Pharmacologic Interventions for Infantile Hemangioma: A Meta-analysis

Chinnadurai¹,

Fonnesbeck

Snyder

et al. 2016

Pediatrics

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“…En sık ülser görülen bölgeler de dudak, boyun ve anogenital bölge olarak belirtilmiştir. Kanama hastaların %41'inde, enfeksiyon ise %16'sında izlenmiştir 14 . Fonksiyonel organ tehdidi, İH'lerin lokalizasyonuna göre değişmektedir (Tablo 1).…”

Section: Komplikasyonları Nedir?unclassified

Infantile Hemangioma

Ersoy‐Evans¹

2011

Turkderm

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“…1,3 De esta manera, se evita la aparición de determinadas complicaciones; la más frecuente es la ulceración, que puede aparecer en un 5%-10% de los casos. 4 No hay que olvidar otras complicaciones, como el compromiso de órganos vitales, que pueden surgir según la localización de los hemangiomas.…”

Section: Introductionunclassified

Hemangioma mamario en una lactante con aparente mastitis. Caso clínico

Jiménez

Navarro

Domínguez

et al. 2018

Arch Argent Pediatr

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Presentación de casos clínicos RESUMENLa patología mamaria en pediatría es infrecuente. El hallazgo de una masa a nivel mamario en un lactante es una situación poco común. Los posibles diagnósticos a esta edad son absceso mamario, mastitis, ingurgitación mamaria por estimulación hormonal materna y hemangioma. Es importante llegar al diagnóstico adecuado para emplear un tratamiento acorde y evitar la aparición de complicaciones de dichas patologías. Se presenta un caso de una lactante con una masa en la mama derecha detectada desde el nacimiento. Inicialmente, se trató como una mastitis, pero dada la mala evolución, se plantearon diagnósticos diferenciales y se concluyó que se trataba de un hemangioma. Debido a la ulceración de la lesión, junto con el riesgo existente de desarrollar hipoplasia mamaria, se decidió iniciar tratamiento con propanolol, con resolución casi completa de la tumoración. Palabras clave: hemangioma infantil, enfermedades de la mama, úlcera, propanolol. ABSTRACTMammary pathology is infrequent during childhood. It is rare the probability of finding a breast mass in an infant. The most frequent possible diagnoses at this age are breast abscess, mastitis, breast engorgement due to maternal hormonal stimulation and hemangioma. Reaching the proper diagnosis is essential in order to apply a suitable treatment and avoid the potential disease complications. We present the case of a female infant having a mass in the right breast from birth. Initially the entity was treated as mastitis. Nevertheless, the bad evolution made necessary considering the differential diagnosis. It was concluded to be a hemangioma. Due to the lesion ulceration and the potential risk of developing breast hypoplasia, treatment with propranolol was started. The tumor was almost completely resolved.

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Multicenter Prospective Study of Ulcerated Hemangiomas

Cited by 222 publications

References 10 publications

Pharmacologic Interventions for Infantile Hemangioma: A Meta-analysis

Pharmacologic Interventions for Infantile Hemangioma: A Meta-analysis

Infantile Hemangioma

Hemangioma mamario en una lactante con aparente mastitis. Caso clínico

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