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Incidence and clinical factors associated with ulceration in infantile hemangiomas
Esteban Fernández Faith1, Sonal D Shah2, Mitchell Braun3
1Division of Dermatology, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio.
Background:
Ulceration is an important complication in infantile hemangiomas (IHs). Prior to the use of β-blockers, the estimated incidence of this complication in a referral population was between 15% and 30%. The incidence and factors associated with ulceration have not been systematically studied since the emergence of β-blocker therapy.
Objective:
Examine the incidence and clinical predictors for ulceration in IHs.
Methods:
Retrospective study at tertiary referral centers.
Results:
Compared with a previous large pre-propranolol cohort study, ulceration occurred at a significantly lower incidence of 11.4%. Clinical factors associated with ulceration included partial segmental morphology, location in the diaper area, and size greater than 5 cm. Higher risk of ulceration in Black patients was observed, suggesting barriers to care including delayed diagnosis and referral to specialty care.
Limitations:
Retrospective design at tertiary referral centers.
Conclusion:
Compared with reports before the use of β-blockers became widespread, the incidence of ulceration in IHs has decreased. However, it continues to be a relatively frequent complication of IH.
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