Prompt recognition and early referral of high-risk lesions are among the key points of a new multidisciplinary AAP clinical report on infantile hemangiomas (IHs).
In Diagnosis and Management of Infantile Hemangioma, published in the October issue of Pediatrics (2015;136:e1060-e1104), the authors provide evidence that large, plaque-like (segmental) IHs and those involving areas of moisture or friction (e.g. lips, perineum) are most likely to ulcerate and scar. Other lesions frequently associated with complications are those involving the eye (visual disturbance), other areas of the face (disfigurement), airway (airway obstruction) and liver (high-output cardiac failure and hypothyroidism).
The authors also present evidence that most IHs grow earlier and more rapidly than once thought, completing 80% of their growth by 5 months of age. They conclude that complications from IHs are best avoided through early referral and management of “high-risk” lesions.