Overview
Infantile haemangiomas are common benign vascular tumors of infancy, often localized but with segmental types carrying higher complication rates and potential associations with PHACE syndrome 2.Diagnosis
Clinical appearance as localized or segmental skin lesions 2.
Imaging (ultrasound, CT, MRI) may be necessary for deeper or internal lesions 3.
Complications such as ulceration, bleeding, or organ obstruction should prompt further evaluation 23.Management
First-line treatments:
- Systemic corticosteroids for segmental haemangiomas to arrest growth and reduce complications 2.
Adjunctive treatments:
- Propranolol for proliferating haemangiomas, with specific dosing protocols outlined in consensus guidelines 1.
- Close monitoring for adverse effects, particularly with corticosteroid use 2.Special Populations
Pediatrics: Early recognition and intervention are crucial for reducing morbidity in infants with segmental haemangiomas 2.
Comorbidities: Consider potential side effects like hypertension, cushingoid features, and growth suppression with corticosteroid therapy 2.Key Recommendations
Initiate systemic corticosteroids for segmental haemangiomas to prevent growth and manage complications (Evidence: Moderate 2).
Use propranolol for proliferating infantile haemangiomas following established dosing and monitoring protocols outlined in consensus guidelines (Evidence: Expert opinion 1).
Early multidisciplinary team involvement is beneficial for managing complications and side effects in infants with segmental haemangiomas (Evidence: Expert opinion 2).References
1 Solman L, Glover M, Beattie PE, Buckley H, Clark S, Gach JE et al.. Oral propranolol in the treatment of proliferating infantile haemangiomas: British Society for Paediatric Dermatology consensus guidelines. The British journal of dermatology 2018. link
2 Phan TA, Adams S, Wargon O. Segmental haemangiomas of infancy: A review of 14 cases. The Australasian journal of dermatology 2006. link
3 Tan TH, Ong KL. Multiple haemangioma/haemangioendothelioma. Singapore medical journal 2001. link
4 McFadden N, Falk ES. Infantile acropustulosis. Cutis 1985. link