Hemangioma

Benign vascular lesions that typically appear during the first weeks of life as blue or pink macules or patches.

Some lesions can be problematic, requiring identification and early treatment and/or referral.

First-line therapy is systemic beta-blockers (such as propranolol).

Infantile hemangiomas, referred to by many simply as "hemangiomas," are benign vascular lesions. Typically they appear during the first weeks of life as blue or pink macules or patches. They subsequently enter a proliferative phase and may become elevated above the surrounding skin surfaces. This growth pattern distinguishes hemangiomas from other vascular lesions. The proliferative growth phase of most hemangiomas is usually completed by the age of 5 months; 80% of growth typically occurs by the end of the third month. Thereafter involution occurs with 90% completion by age 4 years.[1]Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas. Pediatrics. 2019 Jan;143(1): e20183475. https://pediatrics.aappublications.org/content/143/1/e20183475.long http://www.ncbi.nlm.nih.gov/pubmed/30584062?tool=bestpractice.com Complete resolution is possible, but in many cases cutaneous stigmata remain, with redundant fibro-fatty tissue and telangiectasias.[2]Garzon MC. Infantile hemangioma. In: Callen JP, Horn TD, Mancini AJ, et al, eds. Dermatology. Vol. 2. 2nd ed. St. Louis, MO: Elsevier; 2008:1565-80.[3]Chang LC, Haggstrom AN, Drolet BA, et al. Growth characteristics of infantile hemangiomas: implications for management. Pediatrics. 2008 Aug;122(2):360-7. http://www.ncbi.nlm.nih.gov/pubmed/18676554?tool=bestpractice.com Congenital hemangiomas are distinct from infantile hemangiomas. These are vascular lesions that sometimes have a similar clinical appearance to infantile hemangiomas but are fully formed at birth. Specific subtypes of congenital hemangiomas include rapidly involuting congenital hemangiomas and non-involuting congenital hemangiomas. The term "hemangioma" is sometimes used to describe acquired lesions in adults (e.g., cherry hemangioma). These benign lesions rarely undergo involution.