Infantile hemangioma

A common benign vascular tumor in infants

Infantile hemangioma is a benign vascular tumor that occurs in infants. It is the most common tumor of infancy, characterized by a rapid growth phase followed by a slow involution phase. These tumors are composed of blood vessels and are typically found on the skin, although they can occur in other organs.

Presentation

Infantile hemangiomas usually appear within the first few weeks of life. They often start as a small red mark or patch on the skin and can grow rapidly during the first few months. The growth phase is typically followed by a period of stabilization and then a slow involution over several years.

Types

There are several types of infantile hemangiomas, including:

• Superficial hemangiomas: These are located on the surface of the skin and appear bright red.
• Deep hemangiomas: These are located beneath the skin and may appear bluish.
• Mixed hemangiomas: These have both superficial and deep components.

Pathophysiology

The exact cause of infantile hemangiomas is not well understood, but they are thought to arise from endothelial cells that line blood vessels. During the growth phase, there is rapid proliferation of these cells, leading to the formation of the tumor. The involution phase is characterized by apoptosis and regression of the vascular tissue.

Diagnosis

Diagnosis of infantile hemangioma is primarily clinical, based on the appearance and growth pattern of the lesion. In some cases, imaging studies such as ultrasound or MRI may be used to assess the extent of the hemangioma, especially if it is located in a critical area or if there are concerns about complications.

Complications

While most infantile hemangiomas are harmless and resolve on their own, some can lead to complications, including:

• Ulceration: The surface of the hemangioma can break down, leading to pain and risk of infection.
• Obstruction: Hemangiomas located near the eyes, nose, or mouth can interfere with vision, breathing, or feeding.
• Cosmetic concerns: Large or prominent hemangiomas can cause significant cosmetic issues.

Management

The management of infantile hemangiomas depends on their size, location, and potential for complications. Options include:

• Observation: Many hemangiomas do not require treatment and can be monitored for spontaneous involution.
• Pharmacological treatment: Propranolol, a beta-blocker, is commonly used to treat problematic hemangiomas. Other medications include corticosteroids and vincristine.
• Surgical intervention: In some cases, surgical removal may be necessary, especially if the hemangioma is causing significant problems or has not responded to medical treatment.

Prognosis

The prognosis for infantile hemangiomas is generally excellent. Most hemangiomas undergo complete or near-complete involution by the age of 5 to 10 years. However, some may leave residual skin changes, such as telangiectasia or scarring.

Related pages

• Vascular tumor
• Endothelial cell
• Propranolol
• Corticosteroid

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