Pathogenesis and Treatment of Infant Skin Strawberry Hemangiomas

Sasaki, Gordon H.; Pang, Cho Y.; Wittliff, James L.; Zarem, Harvey A.

doi:10.1097/00006534-198403000-00004

Cited by 41 publications

(53 citation statements)

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“…• Blood pressure check • Heart rate check • Temperature determination to evaluate for hypothermia • Observation for bronchospasm and SpO 2 Injection if required were repeated after every 3 weeks and all the injections were given by a single operator to rule out individual variability, chest radiograph were repeated at the end of 1 year as a known complication of bleomycin is pulmonary fibrosis. Findings were noted down on a specially designed proforma and relevant statistics were applied to the data obtained.…”

Section: Protocolmentioning

confidence: 99%

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Comparative Analysis of Intralesional Sclerotherapy with Sodium Tetradecyl Sulfate Versus Bleomycin in the Management of Low Flow Craniofacial Soft Tissue Vascular Lesions

Bajpai¹,

Bajpai²

2011

J. Maxillofac. Oral Surg.

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Objective Comparison of the efficacy of bleomycin over sodium tetradecyl sulfate (STS) when given intralesionally in the treatment of oral and maxillofacial venous malformation. Methods 16 patients with venous malformation in craniofacial region were randomly divided into two groups of eight. Group 1 was given intralesional injection of bleomycin and group 2 was injected with STS. All the cases were evaluated for a minimum period of two and a maximum of 3 years. Results Efficacy of bleomycin was found to be superior to STS, when used as intralesional sclerotherapic agent. Most of the vascular lesions of group 1 resolved after first dose giving a cure rate of 87.5% and no recurrence was observed. Group 2 patients however, required 4-6, a mean of five repeated dosage of intralesional STS before their lesions started to resolve and three patients reported with recurrence within 2 years, giving an overall effective response rate of 62.5%. Conclusion Bleomycin under selected conditions appears to be an excellent therapy for treating soft tissue vascular lesions of low flow nature in craniofacial region. Predictable results were obtained with a high success rate. No systemic or pulmonary complications occurred.

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Section: Protocolmentioning

confidence: 99%

“…Proliferating hemangiomas have been shown to have estradiol-17 beta-receptors in the cytoplasm and corticosteroid treatment has been theorized to block these receptors [2]. Steroid treatment has become a first line of treatment for proliferating lesions.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Intralesional Sclerotherapy with Sodium Tetradecyl Sulfate Versus Bleomycin in the Management of Low Flow Craniofacial Soft Tissue Vascular Lesions

Bajpai¹,

Bajpai²

2011

J. Maxillofac. Oral Surg.

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“…26,27 The possibility that estrogen regulation is involved in the growth of infantile hemangioma is suggested by the increased incidence in females, evidence of ER positivity in proliferating tumors, and elevated levels of circulating 17-␤ estradiol in affected children. 28 A possible link between estrogen and hypoxia mediated neovascularization in the pathogenesis of infantile hemangioma has not been previously examined.…”

mentioning

confidence: 99%

Hypoxia-Induced Mediators of Stem/Progenitor Cell Trafficking Are Increased in Children With Hemangioma

Kleinman

Greives

Churgin

et al. 2007

ATVB

194

158

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Objective— The mechanism of neovascularization during the proliferative phase of infantile hemangioma is poorly understood. It is known that circulating bone marrow-derived endothelial progenitor cells (EPCs) form new blood vessels in ischemic tissues using mediators regulated by the transcription factor, HIF-1α. Mobilization of EPCs is enhanced by VEGF-A, matrix metalloproteinase (MMP)-9, and estrogen, whereas homing is secondary to localized expression of stromal cell-derived factor-1α (SDF-1α). We examined whether these mediators of EPC trafficking are upregulated during the proliferation of infantile hemangioma. Methods and Results— Surgical specimens and blood samples were obtained from children with proliferating hemangioma and age-matched controls (n=10, each group). VEGF-A and MMP-9 levels were measured in blood, and tissue sections were analyzed for SDF-1α, MMP-9, VEGF-A, and HIF-1α. The role of estrogen as a modulator of hemangioma endothelial cell growth was also investigated. We found that all these mediators of EPC trafficking are elevated in blood and specimens from children with proliferating infantile hemangioma. In vitro, the combination of hypoxia and estrogen demonstrated a synergistic effect on hemangioma endothelial cell proliferation. Conclusions— These findings demonstrate that proliferating hemangiomas express known mediators of vasculogenesis and suggest that this process may play a role in the initiation or progression of this disease.

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“…Researches have shown that proliferating haemangiomas have estradiol-17-beta-receptors in their cytoplasm and administration of steroids blocks these receptors. 7 The second hypothesis states that the cells of origin for vascular development have their precursors located at distant body sites say for example the bone marrow and the placenta. It during embryogenesis and vasculogensis that these precursor cells instead of following the routine vascular pathways to the point of development take a detour and result in vascular malforamtions as well a haemangiomas.…”

Section: Discussionmentioning

confidence: 99%