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Hemangioma
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/hemangioma/DS00848
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Definition
A hemangioma — once known as a strawberry hemangioma — is a birthmark that appears as a bright red patch or a nodule of extra blood vessels in the skin. It grows during the first year of life, and then recedes over time. A hemangioma is usually benign and isn't associated with other medical conditions.
Most often hemangioma doesn't require treatment. By age 10, a child who had a hemangioma in infancy usually has little visible trace of the growth.
Symptoms
A hemangioma, which is sometimes referred to as infantile hemangioma, may be present at birth but more often appears during the first several weeks of life. It starts out as a flat red mark anywhere on the body, most often on the face, scalp or back of the neck. Usually a child has only one mark, but some children may have more than one, particularly if they're part of a multiple birth.
During your child's first year, the red mark becomes a spongy mass that protrudes from the skin — often growing rapidly to 2 or 3 inches (about 5 to 7.6 centimeters) in diameter. The hemangioma then stops growing and enters a rest phase. Eventually, it begins to slowly disappear.
Half of all hemangiomas resolve by age 5, and nearly all hemangiomas are resolved by age 10. Although the color of the birthmark also fades, faint — but permanent — discoloration of the skin or residual extra skin may remain.
When to see a doctor
Your child's doctor will monitor the hemangioma during routine checkups. Contact your child's doctor between visits if the hemangioma bleeds, forms a sore or bruise, becomes firm, appears infected, or grows suddenly over one or two days.
There are other blood vessel growths that can be present at birth that aren't true hemangiomas, such as port wine stains and vascular formations that may require medical attention. You may need to consult a dermatologist if you're concerned your child's birthmark isn't an infantile hemangioma.
Causes
A hemangioma consists of an abnormally dense group of extra blood vessels. It's not clear what causes the blood vessels to group together, although some research suggests a link between hemangiomas and certain proteins produced by the placenta during pregnancy.
Risk factors
Hemangiomas occur more often in:
- Females
- Premature babies
- White infants
Complications
Occasionally, a hemangioma can break down and develop a sore. This can lead to pain, bleeding, scarring or infection. Depending on where the hemangioma is situated, it may interfere with your child's vision, breathing, hearing or elimination, but this is rare.
Tests and diagnosis
A hemangioma is diagnosed based on appearance. Diagnostic tests aren't usually needed.
Treatments and drugs
The majority of hemangiomas never need any form of treatment. Treatment of hemangiomas is somewhat controversial. Some parents feel that hemangioma treatment is necessary because the marks can be disfiguring and may cause social or psychological problems. Doctors, however, may be hesitant to treat a hemangioma that isn't causing physical problems because hemangiomas usually fade gradually without treatment, and because treatments have potential side effects. If the growth interferes with your child's vision or causes other problems, treatment options may include:
- Laser surgery. Lasers can stop the growth of a hemangioma. Sometimes lasers can be used to remove a hemangioma or treat sores on a hemangioma that won't heal. The risks are potentially serious and include pain, infection, bleeding, scarring and changes in skin color.
- Corticosteroid medications. Corticosteroids can be injected, given by mouth or applied to the skin. These medications are most effective when they're given during the growth phase. They're used to stop the growth of the hemangioma and sometimes reverse it. Long-term or repeated treatment may be needed. The risks are potentially serious and include poor growth, high blood sugar, high blood pressure and clouding of the normally clear lens of the eye (cataract).
Research to find other treatments with fewer side effects is ongoing. Some newer, though still experimental, treatments include beta blockers, interferon alfa and topical immune suppressants.
If you're considering treatment for your child's hemangioma, weigh the pros and cons with your child's doctor. Remember, most infantile hemangiomas disappear on their own during childhood.
- What is a vascular birthmark? American Academy of Dermatology. http://www.aad.org/public/publications/pamphlets/common_vascular.html. Accessed July 12, 2010.
- Metry DW. Epidemiology; pathogenesis; clinical features; and complications of infantile hemangiomas. http://www.uptodate.com/home/index.html. Accessed July 7, 2010.
- Metry DW. Management of infantile hemangiomas. http://www.uptodate.com/home/index.html. Accessed July 7, 2010.
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