Definition
A blood sponge is a benign tumour that is caused by a proliferation of small blood vessels in the skin. Blood sponges are not prone to malignant degeneration. Since they consist of tiny blood vessels, they shimmer reddish or bluish and are slightly raised.
Blood sponges, technically known as haemangiomas, are present in about one third of cases from birth. The remaining haemangiomas occur around the third to fourth week of life. About one to three percent of all babies are affected by a blood sponge. Blood sponges occur about five times more frequently in girls than in boys. Another important special form of hemangioma is the cavernous hemangioma.
Causes
Why blood sponges develop is not really clarified yet. It is assumed that in many cases a hereditary component is present. There are no measures for the prevention of a blood sponge in a newborn child. One theory to explain the causes of a blood sponge is that blood sponges are caused by a defective regulation of the vascularization in early pregnancy.
Diagnosis
Mostly the diagnosis of blood sponge can be made as a gaze diagnosis. This means that the appearance of a haematopoietic sponge is usually relatively characteristic, so that the physician can make the diagnosis based on the appearance without the need for further diagnostics. In some cases, however, an ultrasound examination and, in very rare cases, a computer tomography follows in order to be able to assess the extension of the dry rot inwards. In addition, the hemangioma should be measured so that the size can be compared in further controls. In the best case, the doctor will also take photographs, so that the blood sponge can be compared in further controls.
Associated symptoms
Blood sponges are not usually accompanied by other symptoms. They do not itch and are not painful. Sometimes they can be a little pressure sensitive.
Blood sponges are benign tumours that are basically harmless. In addition to the haemangioma visible from the outside, there are also internal haemangioma that do not grow on the skin and are therefore not visible from the outside. These internal haemangiomas can impair internal organs through their growth by compressing structures.
Depending on their location, internal haemangiomas can cause breathing difficulties, problems with food intake or jaundice. Hearing and vision may also be affected by internal haematopoietic sponges. If a child has several external haematopoietic sponges, a doctor should also check for internal haematopoietic sponges using ultrasound.
Treatment
As a rule, a blood sponge does not need to be treated. Often it even shrinks over time until it finally disappears completely. However, this process takes several years.
Since it is a benign tumor, a hemangioma is usually only removed for cosmetic reasons, for example if it is prominently located on the face. The face and neck are by far the most common locations of a haemangioma, which is sometimes perceived as disfiguring by those affected, so that they decide to have it removed. Since more than half of the haemangioma regresses during the first year of the child’s life, removal during childhood should be avoided, because even removal can leave disfiguring scars under certain circumstances.
If a haematopoietic sponge is to be removed, this is usually done in several sessions with the help of cold therapy (cryotherapy) or laser therapy. Both icing and laser treatment stop the growth and cause the tumour to fade slowly until it has disappeared completely. Icing is often poorly tolerated by children because it is painful.
In the past, irradiation was also used for removal, but since the side effects were too great, this treatment method was abandoned. Sometimes a blood sponge is also removed surgically. This is especially considered when a blood sponge grows close to important structures such as the eye or ear.
In some cases a haemangioma is also attempted to be treated with cortisone preparations, but this method has increasingly been replaced by the use of propanolol, a beta-blocker. In addition to the conventional methods of removing a haemangioma, freezing and lasering, beta blockers also have an effect on haemangioma. Beta blockers are normally used to treat cardiac arrhythmia, high blood pressure or heart failure.
However, it has been discovered by chance that they also work on haematopoietic sponges in newborns. Beta-blockers can be used in hemangioma due to various effects: On the one hand, they lead to a constriction of blood vessels, inhibit vascular proliferation (vessel growth) and can cause the programmed cell death of cells. All these three effects favour the regression of a haemangioma.
Beta-blockers can be used in the treatment of the blood sponge from the fifth week and are administered in the form of a drinking solution. As a rule, the beta-blocker propranolol is used. Since 2014 beta-blockers have also been officially approved for the treatment of haemangioma, so that they no longer have to be used as so-called off-labe-use.
