Completely ulcerated infantile hemangioma: a diagnostic challenge

Area of Science:

• Pediatric Dermatology
• Vascular Anomalies
• Clinical Case Reports

Background:

• Infantile hemangiomas (IHs) are common benign vascular tumors in infants.
• Ulcerated infantile hemangiomas (UIH) present diagnostic challenges and can be misdiagnosed.
• Prompt diagnosis and treatment are essential for optimal outcomes in UIH.

Purpose of the Study:

• To report a case of a completely ulcerated infantile hemangioma misdiagnosed initially.
• To highlight the diagnostic process including clinical, histological, and immunohistochemical findings.
• To emphasize the efficacy of propranolol in treating UIH.

Main Methods:

• A case report of a 5-month-old infant with a left thigh ulcer.
• Diagnostic workup included clinical assessment, biopsy for histology, and GLUT-1 immunohistochemistry.
• Treatment involved systemic propranolol administration.

Main Results:

• The infant's lesion was confirmed as an ulcerated infantile hemangioma (UIH).
• Systemic propranolol treatment resulted in rapid ulcer healing within 3 weeks.
• Complete recovery was achieved with 18 months of treatment, showing no relapse.

Conclusions:

• Ulcerated infantile hemangioma should be considered in the differential diagnosis of pediatric ulcers.
• GLUT-1 immunohistochemistry is crucial for confirming UIH diagnosis.
• Systemic propranolol is an effective and safe treatment for UIH, leading to rapid healing and long-term recovery.