Hemangioma, capillary infantile

Capillary Infantile Hemangioma is a common type of vascular tumor that typically appears in infancy. This benign tumor is characterized by an abnormal proliferation of blood vessels and is most often found on the skin, although it can also occur in internal organs. The condition is notable for its bright red appearance, which is due to the high density of capillaries. Capillary infantile hemangiomas are distinct from other types of hemangiomas due to their growth phase and potential for involution.

Etiology and Pathogenesis

The exact cause of capillary infantile hemangiomas remains unclear, but it is believed to involve a combination of genetic and environmental factors. Some studies suggest a link to certain maternal factors during pregnancy, such as advanced maternal age, preeclampsia, and the use of assisted reproductive technologies. The pathogenesis involves the rapid proliferation of endothelial cells leading to the formation of a vascular mass.

Clinical Presentation

Capillary infantile hemangiomas typically present in the first weeks of life as a small red mark and undergo a rapid growth phase during the first year. This is followed by a slow involution phase where the hemangioma gradually decreases in size and may completely disappear by adolescence. They are most commonly located on the head and neck, but can occur anywhere on the body.

Diagnosis

Diagnosis of capillary infantile hemangioma is primarily clinical, based on the characteristic appearance and growth pattern. In uncertain cases, imaging studies such as ultrasound or MRI can be helpful in confirming the diagnosis and assessing the extent of the lesion. Biopsy is rarely needed.

Treatment

The treatment of capillary infantile hemangiomas has evolved significantly over the years. Observation is often the first approach, as many hemangiomas will involute without intervention. For lesions that are problematic due to their size, location, or potential for complications, treatments may include beta-blockers (most notably propranolol), corticosteroids, laser therapy, and, in rare cases, surgery.

Prognosis

The prognosis for capillary infantile hemangioma is generally excellent, with many lesions completely involuting by school age. However, some hemangiomas can leave residual skin changes, such as telangiectasia, fibrofatty tissue, or atrophic skin. Complications, while rare, can include ulceration, infection, and, in the case of large or strategically located hemangiomas, functional impairment or cosmetic concerns.

Epidemiology

Capillary infantile hemangiomas are the most common tumors of infancy, affecting approximately 5-10% of infants. There is a higher prevalence in females, premature infants, and those of Caucasian descent.