This delightful baby’s hemangioma was nearly imperceptible at birth and grew to be this rather impressive lesion. I advised the parents to take lots of pictures because by preschool it will probably be gone. Infantile hemangiomas are benign tumors of vascular endothelium, frequently causing angst in the parents. They are the most common tumors of childhood
Even though hemangiomas are benign (non-cancerous) and self-limited (will stop growing on their own), they can cause ulcers or be disfiguring.
The goals of hemangioma management are:
- Prevention or reversal of life-threatening or function-threatening complications (like inability to swallow or breathe)
- Prevention or minimization of disfigurement from residual skin changes (common for lesions on the lip, nose and ear)
- Minimization of psychological distress for the patient (and family)
- Treat any ulceration to minimize scarring, bleeding, infection, and pain
Individualized care is based upon size of the lesion(s), what it looks like, location, presence or possibility of complications, potential for scarring or disfigurement, the age of the patient, and the rate of growth or involution (shrinking) at the time of evaluation
“Active nonintervention” is the mainstay of therapy for most uncomplicated hemangiomas because hemangiomas involute spontaneously. This means to intervene only when necessary.
I refer to a dermatologist, vascular anomalies team or other subspecialist if the family would like further information or hemangioma involves
- Lesions in the airway, liver, or gastrointestinal tract
- Lesions in the periorbital region
- Very large, rapidly growing cutaneous hemangioma
Steroids are the first-line treatment option. Propranolol may be second-line. Vincristine (a cancer medication) and interferon alpha (an immune-modulator medication) may be considered for aggressive hemangiomas otherwise not responsive to the first two therapies.
Hope this helps.
(Consent, of course, obtained from the parents)
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