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Ulcerated hemangiomas: clinical features and management
Siriwan Wananukul1, Susheera Chatproedprai
1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Summary
Ulcerated hemangiomas, common in infants, frequently affect the head and neck. Topical or systemic antibiotics are effective first-line treatments, with flashlamp-pumped pulsed-dye laser therapy showing high success rates for resistant cases.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
- Tumor Complications
Background:
- Hemangioma is the most common pediatric tumor.
- Ulceration is the most frequent complication of infantile hemangioma, causing pain and potential infection.
- Understanding clinical features and effective management is crucial for improving outcomes.
Purpose of the Study:
- To review the clinical characteristics of ulcerated hemangioma.
- To evaluate the effectiveness of different treatment modalities for ulcerated hemangioma.
- To identify optimal management strategies for this common complication.
Main Methods:
- Retrospective study of 41 patients with ulcerated hemangioma at a pediatric dermatology clinic (1992-2001).
- Review of medical records to analyze demographics, hemangioma type, location, age at ulceration, and treatment outcomes.
- Evaluation of treatments including antibiotics, oral prednisolone, flashlamp-pumped pulsed-dye laser (FPDL), and surgical excision.
Main Results:
- Superficial hemangiomas were most common (51%), predominantly affecting the head and neck (51%).
- Antibiotics were successful in 46% of cases; FPDL achieved healing in 94% of patients who failed antibiotic therapy within 1-3 treatments.
- Ulceration occurred at a mean age of 3.9 months.
Conclusions:
- Head and neck are the most common sites for ulcerated hemangioma.
- Topical and systemic antibiotics serve as effective first-line management.
- Flashlamp-pumped pulsed-dye laser is a highly effective treatment for refractory ulcerated hemangioma.