Pediatric Vascular Anomalies: An Overview of Management

Hon,; Shen, P.; Li, Joshua; Chow, Chi-Ming; Luk, D

doi:10.4137/cmd.s11305

Cited by 3 publications

(7 citation statements)

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“…16,17 Deep lesions are bluish and dome-shaped and are noted on average 1 month later than superficial hemangiomas and reach their maximun size between 1 and 2 years of age. 18,19 Deep infantile hemangiomas feel like a "bag of worms" and are compressible. 16 Approximately 60% of infantile hemangiomas are superficial, 15% deep, and 25% mixed superficial and deep.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…18 Rapidly-involuting congenital hemangiomas typically shrink rapidly after birth and disappear by 6 to 12 months of age. 19 Non-involuting congenital hemangiomas, on the other hand, do not change after birth. Other differential diagnoses include tufted angioma, Kaposiform hemangioendothelioma, pyogenic granuloma, infantile hemangiopericytoma, glomangiomatosis, port-wine stain, salmon patch, venous malformation, and lymphatic malformation.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Facial, segmental, or large-sized lesions are more likely to have incomplete involution. 19,22 The condition can be unsightly and cosmetically disfiguring, especially if it occurs on the face. The quality of life may be adversely affected due to psychosocial sequelae, although a recent study showed that affected children do not have a negative quality of life or low self-esteem.…”

Section: Complicationsmentioning

confidence: 99%

“…10,29 Lesions on the tip of the nose tend not to respond well to steroid treatment. 19 Side effects are increased risk for immunosuppression, hypertension, Cushing's syndrome, adrenal suppression, cataracts, glaucoma, diabetes mellitus, gastrointestinal hemorrhage, osteopenia/ osteoporosis, and growth retardation. 27 To minimize adrenal and growth suppression, it is recommended that the steroid should be given in a single dose in the morning.…”

Section: Managementmentioning

confidence: 99%

“…The medication is usually given subcutaneously for a few months. 19 Neurotoxi city such as spastic diplegia and developmental delay occurs in 10 to 30% of patients. 24 Other side effects include fever, irritability, depression , anemia, neutropenia, thrombocytopenia, hypothyroidism, and hepatotoxicity.…”

Section: Managementmentioning

confidence: 99%

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Infantile Hemangioma

Leung¹,

Barankin²,

Hon³

2014

Pediatr Neonatal Nurs Open J

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Infantile hemangiomas typically appear in the first few weeks of life as areas of pallor, followed by telangiectatic patches. They then grow rapidly in the first 3 to 6 months of life. Superficial lesions are bright red, protuberant, and sharply demarcated and are often referred to as "strawberry hemangiomas". Deep lesions are bluish and dome-shaped, feel like a "bag of worms", and are compressible. Infantile hemangiomas have a predilection for the head and neck region. Most infantile hemangiomas exist as solitary lesions. Infantile hemangiomas continue to grow until 9 to 12 months of age, at which time the growth rate slows down to parallel the growth of the child. Half of these lesions will show complete involution by the time a child reaches age 5; 70% will have disappeared by age 7; and 95% will have regressed by ages 10 to 12. The majority of infantile hemangiomas require no treatment. Indications for active intervention include severe or recurrent hemorrhage unresponsive to treatment, threatening ulceration in areas where serious complications might ensue, interference with vital structures, pedunculated hemangiomas, and significant disfigurement. Treatment options include systemic corticosteroids, intralesional corticosteroids, topical and oral beta blockers, pulsed-dye laser, and less commonly interferon-α or surgical resection. In recent years, propranolol, a nonselective β-blocker, has been preferentially used as a first-line treatment of problematic infantile hemangioma.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Infantile Hemangioma

Leung¹,

Barankin²,

Hon³

2014

Pediatr Neonatal Nurs Open J

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Neonatal Abdominal Hemangiomatosis: Propranolol beyond Infantile Hemangioma

Nip

Hon

Leung

et al. 2016

Case Reports in Pediatrics

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Hemangioma is the most common vascular tumor of infancy; presentation is often as cutaneous infantile hemangioma (IH). Cutaneous hemangioma is a clinical diagnosis. Most IHs follow a benign course, with complete involution without treatment in the majority of cases. Visceral hemangioma often involves the liver and manifests as a life-threatening disorder. Hepatic hemangiomas may be associated with high output cardiac failure, coagulopathy, and hepatomegaly which generally develop between 1 and 16 weeks of age. Mortality has been reportedly high without treatment. We report a rare case of a male infant with neonatal hemangiomatosis with diffuse peritoneal involvement, which mimicked a malignant-looking tumor on imaging, and discuss therapeutic options and efficacy. Propranolol is efficacious for IH but generally not useful for other forms of vascular hemangiomas, tumors, and malformations. In our case of neonatal peritoneal hemangiomatosis, propranolol appears to have halted the growth and possibly expedite the involution of the hemangiomatosis without other treatments.

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Infantile Hemangioma: An Updated Review

Leung

Lam

Leung

et al. 2021

CPR

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Background: Infantile hemangiomas are the most common vascular tumors of infancy affecting up to 12% of infants by the first year of life. Objective: To familiarize physicians with the natural history, clinical manifestations, diagnosis, and management of infantile hemangiomas. Methods: A Pubmed search was conducted in November 2019 in Clinical Queries using the key term "infantile hemangioma". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Results: The majority of infantile hemangiomas are not present at birth. They often appear in the first few weeks of life as areas of pallor, followed by telangiectatic telangiectatic or faint red patches. They then grow rapidly in the first 3 to 6 months of life. Superficial lesions are bright red, protuberant, bosselated or with a smooth surface, and sharply demarcated. Deep lesions are bluish and dome-shaped. Infantile hemangiomas continue to grow until 9 to 12 months of age, at which time the growth rate slows down to parallel the growth of the child. Involution typically begins by the time the child is a year old. Approximately 50% of infantile hemangiomas will show complete involution by the time a child reaches age 5; 70% will have disappeared by age 7; and 95% will have regressed by 10 to 12 years of age. The majority of infantile hemangiomas require no treatment. Treatment options include oral propranolol, topical timolol, and oral corticosteroids. Indications for active intervention include hemorrhage unresponsive to treatment, impending ulceration in areas where serious complications might ensue, interference with vital structures, life- or function-threatening complications, and significant disfigurement. Conclusion: Treatment should be individualized, depending upon the size, rate of growth, morphology, number and location of the lesion (s), existing or potential complications, benefits and adverse events associated with the treatment, age of the patient, level of parental concern, and the physician's comfort level with the various treatment options. Currently, oral propranolol is the treatment of choice for high-risk and complicated infantile hemangiomas. Topical timolol may be considered for superficial infantile hemangiomas which need to be treated and for complicated infantile hemangiomas in patients at risk for severe adverse events from oral administration of propranolol.

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Pediatric Vascular Anomalies: An Overview of Management

Cited by 3 publications

References 0 publications

Infantile Hemangioma

Infantile Hemangioma

Neonatal Abdominal Hemangiomatosis: Propranolol beyond Infantile Hemangioma

Infantile Hemangioma: An Updated Review

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