Hemangioma. New aspects of pathogenesis, differential diagnosis and therapy

• Published in: Hautarzt 2012-02, Vol.63 (2), p.112-120
• Main Author: Höger, P H
• Format: Article
• Language: ger
• Subjects: Child; Child, Preschool; Cryotherapy - methods; Female; Hemangioma - diagnosis; Hemangioma - therapy; Humans; Infant, Newborn; Male; Propranolol - therapeutic use; Skin Neoplasms - diagnosis; Skin Neoplasms - therapy; Vasodilator Agents - therapeutic use
• ISSN: 1432-1173
• DOI: 10.1007/s00105-011-2312-9

With a prevalence of 10–12% infantile hemangiomas (IH) represent the most common skin tumor in infancy. They are characterized by a sequence of growth and, in 90%, spontaneous regression. Special manifestations of IH include hemangiomatosis, congenital hemangioma (RICH/NICH), reticular and segmental hemangiomas (PHACE, PELVIS/SACRAL syndrome). The latter represent a transition between vascular tumor and vascular malformation. Important differential diagnoses of IH include pyogenic granuloma (PG) and hemangioendothelioma (HAE) of which PG is a common, benign vascular tumor with a predilection for the facial region and a proneness to bleed whereas HAE is a slowly growing tumor exhibiting infiltrative growth; unlike IH it is associated with the Kasabach-Merritt syndrome of consumptive coagulopathy. The majority of IHs do not require therapy, however, therapy is absolutely indicated for ulcerating or obstructive IH where propranolol is considered the first-line therapy. Non-obstructive facial IH represents a relative indication for therapy. Cryotherapy is most suitable for IH with diameters below 1 cm and a depth < 4 mm.