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Published on: June 15, 2020
Multicenter prospective study of ulcerated hemangiomas
Sarah L Chamlin1, Anita N Haggstrom, Beth A Drolet
1Division of Pediatric Dermatology, Children's Memorial Hospital and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Insights
Nearly 16% of infants with infantile hemangiomas develop ulcerations, often by 4 months of age. Larger size, specific locations, and types increase ulceration risk in these common vascular tumors.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
- Infant Health
Background:
- Infantile hemangiomas are common benign vascular tumors in infants.
- Ulceration is a frequent complication, causing pain and potential scarring.
- Understanding risk factors for ulceration is crucial for timely intervention.
Purpose of the Study:
- To identify clinical features associated with ulcerated infantile hemangiomas.
- To determine the incidence and timing of ulceration in infantile hemangiomas.
- To characterize risk factors for infantile hemangioma ulceration.
Main Methods:
- Cross-sectional analysis of a prospective cohort study.
- Inclusion of children under 12 years with infantile hemangiomas.
- Collection of demographic, clinical, and treatment data.
Main Results:
- 15.8% of patients (173/1096) experienced ulceration.
- Ulcerated hemangiomas were larger, mixed clinical type, segmental, and located on the lower lip, neck, or anogenital region.
- Ulceration occurred by a median age of 4 months, often during the proliferative phase; 41% experienced bleeding, 16% infection.
Conclusions:
- Ulceration affects nearly 16% of infantile hemangioma patients, typically by 4 months.
- Hemangioma location, size, and type are significant risk factors for ulceration.
- Early presentation to specialists and treatment are more common in infants with ulcerated lesions.
Objective:
To identify clinical features of infants with ulcerated infantile hemangiomas.
Study Design:
Cross-sectional analysis was conducted within a prospective cohort study of children with infantile hemangiomas. Children younger than 12 years of age were recruited. Demographic and prenatal/perinatal information was collected. Hemangioma size, location, subtype, course, complications, and treatments were recorded.
Results:
One thousand ninety-six patients were enrolled, and 173 (15.8%) patients experienced ulceration. Ulceration occurred in 192 (9.8%) of 1960 [corrected] total hemangiomas. Hemangiomas with ulcerations were more likely large, mixed clinical type, segmental morphologic type, and located on the lower lip, neck, or anogenital region. Ulceration occurred at a median age of 4 months, most often during the proliferative phase. Children with ulcerated hemangiomas were more likely to present to a pediatric dermatologist at a younger age and to require treatment. Bleeding occurred in 41% of ulcerated lesions but was rarely of clinical significance. Infection occurred in 16%.
Conclusions:
Ulceration occurs in nearly 16% of patients with infantile hemangiomas, most often by 4 months of age, during the proliferative phase. Location, size, and clinical and morphologic type are associated with an increased risk for development of ulceration.
