Related Experiment Videos
The treatment of hemangiomas: with special reference to the role of steroid therapy
Insights
This review details 25 years of experience managing over 1000 patients with vascular anomalies, including hemangiomas. High-dose Prednisone is highlighted as a key treatment for juvenile capillary hemangiomas.
Area of Science:
- Vascular Surgery
- Pediatric Dermatology
- Medical Genetics
Background:
- Hemangiomas are the most common congenital anomaly.
- Developmental vascular anomalies encompass a wide spectrum of conditions.
- Accurate classification is crucial for prognosis and treatment planning.
Purpose of the Study:
- To present a 25-year clinical experience with over 1000 patients.
- To propose a useful clinical classification for vascular anomalies.
- To evaluate various treatment modalities for hemangiomas and related disorders.
Main Methods:
- Review of a 25-year personal experience with over 1000 patients.
- Analysis of treatment outcomes for surgical excision, irradiation, CO2 freezing, sclerosing agents, cauterization, steroid therapy, and watchful waiting.
- Evaluation of high-dose, short-course Prednisone therapy for juvenile capillary hemangiomas.
Main Results:
- A new clinical classification is proposed to aid in prognosis and therapeutic decisions.
- High-dose, short-course Prednisone therapy demonstrated significant success in treating massive juvenile capillary hemangiomas.
- Several treatment modalities showed disappointing results, while others were effective.
Conclusions:
- A refined classification system improves management of vascular anomalies.
- Prednisone therapy represents a significant advancement for specific hemangioma types.
- Understanding growth, resolution, and etiology is vital for surgical approaches.
Abstract:
Hemangiomas are the most common of all human birth defects. The author has reviewed a 25-year personal experience with treatment of over 1000 patients with a variety of common and rare developmental vascular anomalies. Attention is given to a more useful clinical classification of these disorders. The classification is intended to be helpful in estimating prognosis of the lesions and as a guide to the choice of therapy. Many treatment modalities are evaluated--some successful and some quite disappointing. Surgical excision, irradiation, CO2 freezing, sclerosing agents, cauterization, steroid therapy and watchful waiting are among the treatment methods evaluated. High dose--short course Prednisone therapy has proved to be a major new addition to the treatment of massive juvenile capillary hemangiomas. Numerous misconceptions have appeared in the medical literature. These are noted and a philosophic basis for present day management is suggested for each type angioma. The roles of growth, resolution, histologic picture and sense of deformity are considered in viewing the surgeon's approach to these difficult and challenging problems. Some evidence and speculations are offered as to the etiology, neurogenic influences and physiological dynamics of the various hemangiomas.