Evaluation and management of infantile hemangioma: an overview

Infantile hemangiomas are the most common tumors of infancy and commonly last 7 to 9 years. Although their pathophysiology is not completely understood, recent studies have provided useful information regarding differential diagnosis, assessment approaches, and management options. To enhance understanding of infantile hemangiomas and highlight recent advances in knowledge of pathophysiology and newer diagnostic and therapeutic modalities, a literature search of pertinent articles published between 1985 and 2006 in PubMed was conducted using the term hemangioma with the words types, pathophysiology, treatment, and complications. Despite the generally benign nature of the condition, treatment is required for cosmetic and psychological reasons and requires differential diagnosis, particularly with regard to congenital hemangiomas and vascular and non-vascular tumors, to determine cause and address potential complications such as ulceration. Various emerging treatment modalities are available (interferon, vincristine, cyclophosphamide, bleomycin, imiquimod, becaplermin, and laser therapy) but steroids remain the treatment of choice in cases when hemangiomas require intervention. Overall prognosis in terms of healing hemangiomas using conservative measures is good. Additional research to better understand the pathophysiology and role of genetics is needed. Emerging treatment options should be evaluated through controlled studies to assess effects and side effects.