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[Management of hemangioma in the infant]
1Groupe pluridisciplinaire des malformations vasculaires, Hôpital Lariboisière, Paris.
Insights
Management of infantile hemangiomas in foster children focuses on observation due to their typical regression. Treatment is reserved for high-risk cases impacting function, aesthetics, or posing life-threatening complications.
Area of Science:
- Pediatric Dermatology
- Vascular Lesion Management
- Childhood Oncology
Context:
- Infantile hemangiomas are common benign vascular tumors in children.
- Their management is guided by natural involution and potential complications.
- Foster care status may influence follow-up and treatment accessibility.
Purpose:
- To outline the management strategies for infantile hemangiomas in foster children.
- To identify indications for intervention versus observation.
- To review treatment options for complicated or high-risk hemangiomas.
Summary:
- Infantile hemangiomas typically regress spontaneously, necessitating clinical follow-up as the primary management approach.
- Investigations and interventions are reserved for hemangiomas with poor functional or aesthetic prognosis (e.g., peri-orificial, facial) or life-threatening complications (e.g., subglottic, Kasabach-Merritt Syndrome, diffuse hemangiomatosis).
- Standard treatments include systemic corticosteroids, with options for early surgery or intralesional corticosteroids.
Impact:
- Provides a framework for evidence-based management of infantile hemangiomas in a vulnerable pediatric population.
- Aims to optimize outcomes by focusing resources on cases requiring intervention.
- Highlights the importance of vigilant monitoring for potential complications in foster children.
Abstract:
Foster child hemangioma management depends on its usual spontaneously regressive evolution as it is a transient and benign vascular tumor like lesion. Most of the time clinical follow up is the only management. Investigations are indicated if treatment is needed (for decision and follow up) concerning only hemangiomas with a bad functional or esthetic prognosis (peri-orificial lesions and large locations of the face) or complicated hemangiomas with life-risk as sub glottic hemangioma, Kasabach and Merritt Syndrome, diffuse and liver hemangiomatosis possibly associated to cardiac failure. Basic treatment remains systemic corticosteroids with indications for early surgery or intralesional corticosteroids.