Peds
Hemangioma
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Hemangioma
, Capillary Hemangioma, Strawberry Hemangioma
See Also
Newborn Skin Exam
Epidemiology
Prevalence
: 1.1 - 2.6% of all newborns (10% of infants at one year)
More common in
Premature Infant
s
Signs
Often lesion not present at birth or barely noticeable pale patch of skin
Distribution
Midline
Beard region
Erythematous or violaceous lobulated lesions
Differential Diagnosis
Thrombocytopenia
Cardiac failure
Cutaneous Signs of Spinal Dysraphism
(e.g. sacral Hemangioma)
Associated Conditions
Kasabach-Merritt Syndrome
Tethered Cord
with lumbosacral lesions
See
Cutaneous Signs of Spinal Dysraphism
Course
Develops in first four weeks after birth
Proliferates until 9 to 12 months of age
Spontaneous Resolution
Age 5 years: 50% resolution
Age 7 years: 70% resolution
Age 9 years: 90% resolution
Residual atrophy,
Hypopigmentation
, telangiectases, or scarring may occur
Management
Interventions by Pediatric Dermatology
Compression garment or Coban Tape
Hemangiomas on arms or legs
Biosynthetic dresing every 24 hours
Prednisone
Indicated where Hemangioma compresses eye, airway or other vital conditions
Dose: 3 mg/kg daily for 6-12 weeks
Continue until lesion stops growing or size decreases
Interferon alfa
(if refractory to Steroids)
Pulse
d-dye laser therapy
Management
Indications for referral or further evaluation
Multiple Hemangiomas
Consider
Ultrasound
of the
Abdomen
to evaluate for gastrointestinal and
Liver Lesion
s
Deep Hemangiomas
Large Hemangiomas
Risk of high-output
Heart Failure
Sacral Hemangiomas
See
Cutaneous Signs of Spinal Dysraphism
Airway Hemangioma
May present with
Stridor
Airway Hemangiomas tend to enlarge through the first year of life
Eyelid Hemangioma
May block vision
References
McLaughlin (2008) Am Fam Physician 77: 56-60 [PubMed]
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