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Benign Neonatal Hemangiomatosis
Austinn C Miller1, Elliott S Gordon, Christy R Peterson
1Center for Clinical Studies, Webster, Texas (Dr Miller); Mercer University School of Medicine, Macon, Georgia (Drs Miller, Gordon, Peterson, and Cohen); Department of Pediatrics, Beverly Knight Olson Children's Hospital, Navicent Health, Macon, Georgia (Drs Gordon and Peterson); Skin Care Physicians of Georgia, Macon, Georgia (Dr Cohen); and Department of Pediatrics, Spartanburg Regional Healthcare System, Spartanburg, South Carolina (Dr Bowe).
Background:
Benign neonatal hemangiomatosis (BNH) is a rare, self-limiting subtype of infantile hemangiomas (IHs), in which infants with multiple cutaneous hemangiomas lack visceral involvement. Other subtypes of IHs exist that may mimic BNH and can be life-threatening depending on hemangioma location and size.
Clinical Findings:
At birth, a 29 5 / 7 -week preterm female presented with several pinhead-sized pink papules distributed throughout her body. At 10 days of age, the patient had 12 enlarged domed-shaped red papules in a generalized distribution throughout her body. Over several weeks, the number and size of the domed-shaped red papules continued to increase to a total of 26 located on the head, chest, abdomen, back, legs and arms. They were of firm consistency with both smooth and lobulated surfaces.
Primary Diagnosis:
A diagnosis of BNH was made after extensive workup did not reveal any extracutaneous hemangiomas.
Interventions:
Due to the lack of extracutaneous involvement and low-risk location/size of hemangiomas in our patient, no interventions were pursued and an observation-only approach was implemented.
Outcomes:
The patient remained stable while followed up over 8 months, with the size of the hemangiomas only increasing slightly in proportion to the patient's natural body growth.
Practice Recommendations:
Given the life-threatening nature of certain hemangioma subtypes, it is important to implement a proper workup and subtype diagnosis as early as possible in any infant with multiple hemangiomas.
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