Hemangioma

概述 
理论 
诊断 
治疗 
随访 
资源 

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最后审阅： 19 Aug 2025

最后更新： 15 Mar 2024

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).

定义

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] Complete resolution is possible, but in many cases cutaneous stigmata remain, with redundant fibro-fatty tissue and telangiectasias.[2][3] 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.

病史和体格检查

关键诊断因素

variable onset
pink, red, or blue color
rapid growth
variable compressibility
flat or nodular character

完整详情

其他诊断因素

islands of normal skin
ulceration and bleeding
warmth
history of low birth weight
variable pain
associated defects
beard distribution and stridor
lumbosacral location
multiple lesions
poor infantile feeding, failure to gain weight
high-output cardiac failure

完整详情

危险因素

low birth weight
birth prematurity
white ethnicity
female sex
maternal multiple gestation
advanced maternal age
chorionic villus sampling

完整详情

诊断性检查

首要检查

Doppler ultrasound of hemangioma

完整详情

需考虑的检查

MRI (without and with IV contrast) of hemangioma
biopsy of lesion

完整详情

治疗流程

急症处理

asymptomatic

with functional impairment or cosmetic disfigurement

撰稿人

作者

Kari L. Martin, MD

Associate Professor of Dermatology & Child Health

Pediatric Dermatology

University of Missouri – Columbia

Columbia

利益声明

KLM is an investigator in clinical trials with Scioderm, Lilly, and Durata; payments were received by her institution for these trials. None of these are relevant to this topic.

鸣谢

Dr Kari L. Martin would like to gratefully acknowledge Dr Tobian Muir, Dr Ingrid Polcari, Dr Annette Wagner, and Dr Carla T. Lee, the previous contributors to this topic.

利益声明

TM, IP, and CTL declare that they have no competing interests. AW: none disclosed.

同行评议者

Elena Pope, MD

Head

Department of Dermatology

The Hospital for Sick Children

Toronto

Ontario

Canada

利益声明

EP is an author of a number of references cited in this topic.

Elisabeth Higgins, MD

Consultant Dermatologist

King's College Hospital

London

利益声明

EH declares that she has no competing interests.

Iona Friedan, MD

Professor of Clinical Dermatology and Pediatrics

University of California San Francisco

San Francisco

Disclosures

IF is a consultant for Pierre Fabre Dermatology, which is involved in clinical trials of propranolol for hemangiomas. IF is an author of a number of references cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas. Pediatrics. 2019 Jan;143(1): e20183475.Full text Abstract

Darrow DH, Greene AK, Mancini AJ, et al. Diagnosis and management of infantile hemangioma. Pediatrics. 2015 Oct;136(4):e1060-104.Full text Abstract

Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas. Pediatrics. 2019 Jan;143(1): e20183475.Full text Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials
- Venous malformation
- Arteriovenous malformation
- Lymphatic malformation
More Differentials
Guidelines
- ACR Appropriateness criteria for soft tissue vascular anomalies: vascular malformations and infantile vascular tumors (non-CNS)-child
- Vascular anomalies in childhood: When to treat and when to refer
More Guidelines
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Hemangioma

小结

定义

病史和体格检查

关键诊断因素

其他诊断因素

危险因素

诊断性检查

首要检查

需考虑的检查

治疗流程

asymptomatic

with functional impairment or cosmetic disfigurement

撰稿人

作者

Kari L. Martin, MD

利益声明

鸣谢

利益声明

同行评议者

Elena Pope, MD

利益声明

Elisabeth Higgins, MD

利益声明

Iona Friedan, MD

Disclosures

Peer reviewer acknowledgements

Disclosures

References

Key articles

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials

Guidelines

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