Clinical features

Infantile haemangiomas can occur anywhere in the body. Most frequent sites include (1):

• head and neck - 60%
• trunk - 25%
• limbs -15%

The majority of haemangiomas appear around 2 weeks after birth. About one-third are noticed at birth manifesting as an erythematous macular patch, a blanched area, telangiectasia, or a pseudoecchymotic stain (1)

• life span of infantile haemangiomas can be divided into (1):
  • rapid proliferative phase (0-1 year)
  • slow involuting phase (1-7 years)
  • involuted phase (8-12 years)
• infantile haemangiomas are classified into superficial, deep, or combined forms
  • superficial infantile haemangiomas (include the "strawberry naevus type") appear red, raised, and lobulated, whereas deep lesions have normal overlying skin and appear as raised soft masses, often with a bluish cast (2)
  • morphologic subtypes of infantile haemangiomas include localized and segmental forms (3)
    
    
• haemangiomas that have regressed may sometimes leave behind fibrofatty depositions, overlying anetoderma, and telangiectasia (4)
• ulcerations, bleeding, airway involvement, and vision impairment are some of the complications of haemangiomas
• visceral haemangiomas are more likely in a child who has multiple cutaneous lesions (>5). Most of them are seen on the liver. Other sites include the lungs, brain, and intestines (2)
• large facial infantile haemangiomas have higher rates of complications than small localised haemangiomas and can be associated with neurological, ophthalmologic, and cardiac anomalies - PHACE syndrome (3)
• glucose transporter-1 (GLUT-1) is strongly expressed by the cells of infantile haemangioma (1)

Reference:

• 1. Mulliken JB et al. Case 13-2004. A newborn girl with a large cutaneous lesion, thrombocytopenia, and anemia. N Engl J Med. 2004;350(17):1764-75.
• 2. Spring S et al. Dermacase: infantile hemangioma. CFP 2009;55(4):380-381
• 3. Haggstrom AN et al. Patterns of infantile hemangiomas: new clues to hemangioma pathogenesis and embryonic facial development. Pediatrics 2006;117:698-703
• 4. Garzon MC et al. Vascular malformations: Part I. J Am Acad Dermatol. 2007;56(3):353-70