Hemangiomas

Hemangiomas, the most common tumor of infancy, are generally understood in terms of several well-known facts. Hemangiomas are more common in females than in males (3:1), they are more common in Caucasian populations and in premature infants, and most are located in the head and neck. Additionally, most are single lesions; however, about 20% of patients have multiple lesions. Hemangiomas exhibit a period of rapid postnatal growth. The duration of the proliferative period is variable, but is usually confined to the first year of life. The proliferative period rarely extends to 18 months. The involutional phase is also quite variable occurring over a period of two to nine years. After complete involution, normal skin is restored in about 50% of patients. In other patients the skin may show evidence of telangiectasia, yellowish hypoelastic patches, sagging or fibrofatty patches and scarring, if the lesion ulcerated.

There have been many attempts to categorize hemangioma patients, to allow for a deeper and more practical understanding of this common yet complex disease. Waner and Sueng2 proposed the most useful and practical classification of hemangiomas. In this scheme hemangiomas are classified as superficial , deep or combined. The term superficial hemangioma replaces older terms "capillary hemangioma" or "strawberry hemangioma", and refers to hemangiomas located in the papillary dermis. The deep hemangioma, often slightly blue in color, originates form the reticular dermis or the subcutaneous space and is referred to in other schemes as a "cavernous hemangioma". The combined hemangioma has elements of both of the superficial and the deep.

 

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