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Infantile haemangiomas: Identifying high-risk lesions in primary care
1BPharm (Hons), MD, DH, General Practice Registrar, Westmead Hospital, Westmead, NSW.
Insights
General practitioners can identify high-risk infantile haemangiomas (IHs) in infants, enabling timely intervention for potential complications. Early detection and management of IHs are crucial for better outcomes.
Area of Science:
- Pediatrics
- Dermatology
- Vascular Biology
Background:
- Infantile haemangiomas (IHs) are common benign vascular tumors affecting up to 10% of infants.
- Some IHs present risks for complications and cosmetic concerns, necessitating expert management.
- General practitioners (GPs) play a key role in identifying and coordinating care for high-risk IHs.
Purpose of the Study:
- To provide strategies for identifying high-risk infantile haemangiomas.
- To guide the timely involvement of multidisciplinary teams in IH management.
Main Methods:
- Review of clinical guidelines and literature on infantile haemangioma risk stratification.
- Discussion of key clinical features and associated syndromes requiring specialized care.
Main Results:
- IHs on the lower face/neck may cause airway obstruction.
- Multiple IHs (≥5) are linked to hepatic haemangiomas, cardiac failure, and hypothyroidism.
- IHs near eyes/mouth can lead to amblyopia/feeding issues; large segmental IHs may indicate syndromes (PHACE, PELVIS, LUMBAR).
Conclusions:
- Early identification of high-risk IHs by GPs is essential.
- Prompt referral to a multidisciplinary team ensures appropriate management for complex cases.
- Recognizing IH-associated syndromes is critical for comprehensive infant care.
Background:
Infantile haemangiomas (IHs) are benign vascular tumours that affect up to 10% of infants and arise in the first few weeks-to-months of life. Some are associated with an increased risk of complications and poor cosmetic outcomes. General practitioners (GPs) are ideally placed to identify high-risk IHs and coordinate their management.
Objective:
The aim of this article is to outline strategies to identify high-risk IHs and when to involve a multidisciplinary team.
Discussion:
IHs that involve the lower face or neck can be associated with airway obstruction. Having five or more IHs is associated with hepatic haemangiomas, high-output cardiac failure and hypothyroidism. IHs that involve the eyes or mouth can cause functional impairments such as amblyopia and feeding difficulties, respectively. Large segmental IHs maybe associated with syndromic presentations including PHACE syndrome when on the lower face, PELVIS syndrome when on the perineum and LUMBAR syndrome when on the lower back.
