Infantile Hemangiomas: What Happens After They Resolve?
Infantile hemangiomas (IH), common benign vascular tumors, have a characteristic, natural history that begins with rapid proliferation in the first months of life followed by slow involution that takes 5 to 9 years to complete. For the most part, all IH shrink, but they do often leave a permanent mark of some kind, and the ability to predict how disfiguring that might be could dictate the type of treatment that is indicated.
A recent retrospective cohort study looked at images of IH to determine the sequelae left by infantile hemangiomas after natural involution in order to identify clinical characteristics that could predict the most severe or a particular type of sequelae. The study showed that superficial and deep hemangiomas left significantly fewer sequelae than combined hemangiomas. Hemangiomas with a step or abrupt border of the superficial component left more severe sequelae than those with a smooth border. Superficial hemangiomas with a cobblestone appearance or rough surface left more severe sequelae than those with a smooth surface.
The most common sequelae after involution were telangiectasias, fibrofatty tissue, and anetodermic skin. The average age at which hemangioma completed involution was 3.5 years. The authors conclude that more than half of IHs will leave significant or severe sequelae if left to involute spontaneously, and that their morphology may help predict the risk and nature of major sequelae. They suggest that close follow-up during the first weeks of life will help detect the early morphological changes that suggest a risk of significant sequelae and guide clinicians to consider therapy before unfavorable clinical features develop.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: December 14, 2016
Source: JAMA Dermatology
Adapted from the original article.
[Image: DermNet New Zealand]