Infant hemangioma
Infantile hemangioma (SH; blood sponge of the infant/newborn; synonym: infantile hemangioma) is a congenital vascular tumor that occurs in the first days or weeks/months after birth. The small vessels of the skin, the capillaries, form tangle-like growths and bulges.
Sex ratio: boys to girls is 1: 3.
The prevalence (disease frequency) is 4-5% of all infants. Among premature infants born with less than 1 kg birth weight, infantile hemangioma occurs in up to 22%.
Course and prognosis: Phasic course (proliferation/growth, arrest of growth, and regression/regression over years, in about 90% of cases by the age of ten). Complete healing is possible.
Symptoms – Complaints
The skin shows a light to dark red skin nodule, which can be of varying size.
Location: most often, the hemangioma (blood sponge) is located on the face or neck, but it can also occur on any other region of the body.
Differential diagnoses
- Nevus flammeus (port-wine stain)
- Neonatal hemangiomatosis – multiple hemangiomas of the skin with organ involvement.
- Lymphangioma – lymphatic tumor.
- Arteriovenous malformation AVM) – congenital malformation of blood vessels in which arteries are directly connected to veins.
Pathogenesis (disease development) – etiology (causes)
The hematoma can grow and spread, especially in the first months of life. Occasionally, ulcerations (ulcerations) appear on the surface.
Spontaneous remissions (regressions) usually occur; in some cases, scars remain.
Diagnosis
It is a diagnosis by sight.
Therapy
Often, patients wait to see if the hemangioma spontaneously regresses before starting therapy. If it does not, the following therapeutic options are available:
- Treatment with an oral propranolol (3 mg/kg bw propranolol) (first-line therapy).
- In a study of nearly 1,000 patients with hemangiomas (mean age 17.1 months), rebound occurred in 25.3% of patients after propranolol therapy (1.5-2.5 mg/kg bw). Risk factors were:
- Children at end of therapy <9 months of life versus children between 12 and 15 months of life.
- Deep hemangiomas
- Female sex
- Dye-pulsed laser therapy (second-line therapy).
- Contact cryotherapy
If this has not achieved sufficient success, the following methods can be used:
- X-ray therapy
- Treatment with corticoids (intralesional steroids).
- Vascular surgery
- Embolization (artificial occlusion of blood vessels).
Adult hemangioma
Furthermore, there are also hemangiomas that occur in adulthood. These form suddenly, often after trauma or wound infection. They resemble a fungus in shape and, as in infants, are red in color because they are also composed of blood vessels.Hemangiomas can be removed with a variety of lasers:These lasers, such as the KTP laser, the argon laser, or the krypton ion laser, react with hemoglobin to target the hemangioma without destroying the surrounding tissue.The ruby laser and the dye laser are also used to remove hemangiomas.
