Resumo
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- início variável
- coloração rosa, vermelha ou azul
- crescimento rápido
- compressibilidade variável
- natureza achatada ou nodular
Other diagnostic factors
- ilhas de pele normal
- ulceração e sangramento
- quentura
- história de baixo peso ao nascer
- dor variável
- defeitos associados
- distribuição na área da barba e estridor
- localização lombossacral
- lesões múltiplas
- alimentação infantil de má qualidade, insuficiência para ganhar peso
- insuficiência cardíaca de alto débito
Risk factors
- baixo peso ao nascer
- nascimento prematuro
- etnia branca
- sexo feminino
- gestação maternal múltipla
- idade materna avançada
- biópsia da vilosidade coriônica
Diagnostic investigations
1st investigations to order
- ultrassonografia com Doppler do hemangioma
Investigations to consider
- RNM (sem e com contraste IV) do hemangioma
- biópsia da lesão
Treatment algorithm
assintomático
com comprometimento funcional ou deformidade estética
Contributors
Authors
Kari L. Martin, MD
Associate Professor of Dermatology & Child Health
Pediatric Dermatology
University of Missouri – Columbia
Columbia
MO
Disclosures
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.
Acknowledgements
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.
Disclosures
TM, IP, and CTL declare that they have no competing interests. AW: none disclosed.
Peer reviewers
Elena Pope, MD
Head
Department of Dermatology
The Hospital for Sick Children
Toronto
Ontario
Canada
Disclosures
EP is an author of a number of references cited in this topic.
Elisabeth Higgins, MD
Consultant Dermatologist
King's College Hospital
London
UK
Disclosures
EH declares that she has no competing interests.
Iona Friedan, MD
Professor of Clinical Dermatology and Pediatrics
University of California San Francisco
San Francisco
CA
Disclosures
IF is a consultant for Pierre Fabre Dermatology, which is involved in clinical trials of propranolol for haemangiomas. 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
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
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Malformação venosa
- Malformação arteriovenosa
- Malformação linfática
More DifferentialsGuidelines
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