Summary about Disease
Juvenile hemangiomas, also known as infantile hemangiomas or strawberry marks, are common benign (non-cancerous) vascular tumors that appear in the first few weeks of life. They are characterized by rapid growth in the first few months followed by slow involution (shrinking) over several years. Most hemangiomas do not require treatment and resolve on their own.
Symptoms
Appearance: Typically a bright red, raised or flat patch on the skin. They can also be bluish in deeper tissues.
Location: Can occur anywhere on the body, but most commonly on the head and neck.
Growth: Rapid growth phase (proliferation) in the first few months, followed by a slow involution phase.
Size: Can range from a few millimeters to several centimeters.
Ulceration: Sometimes, hemangiomas can ulcerate (break open) causing pain and potential for infection.
Functional Impairment: Depending on their location, they can interfere with vision, breathing, feeding, or other bodily functions.
Causes
The exact cause of juvenile hemangiomas is not fully understood. However, they are thought to arise from an abnormal collection of blood vessels that proliferate rapidly. Several factors are being researched, including:
Genetic factors: There may be a genetic predisposition in some cases.
Placental factors: Some research suggests a link to placental origin and certain proteins.
Growth factors: Elevated levels of certain growth factors, such as vascular endothelial growth factor (VEGF), are believed to play a role in their development.
Medicine Used
Beta-blockers (Propranolol): This is the most common first-line treatment for problematic hemangiomas. It helps to constrict blood vessels and slow growth.
Topical Beta-blockers (Timolol): Can be used for small, superficial hemangiomas.
Corticosteroids: Less commonly used now, due to side effects, but can be helpful in certain situations.
Laser Therapy: Can be used to reduce the redness and size of hemangiomas, especially in the involution phase.
Surgery: Rarely needed, but may be considered for residual lesions or for hemangiomas that are causing significant functional problems.
Is Communicable
No, juvenile hemangiomas are not communicable. They are not caused by an infection and cannot be spread from person to person.
Precautions
Protect from injury: Avoid scratching, rubbing, or bumping the hemangioma, as this can lead to ulceration.
Monitor for ulceration or infection: Keep the area clean and dry. If ulceration occurs, seek medical attention promptly.
Sun protection: Protect the hemangioma from sun exposure, as this can worsen the redness and potentially affect healing.
Regular check-ups: Follow up with a doctor to monitor the hemangioma's growth and involution.
Be aware of potential complications: If the hemangioma is near the eye, nose, mouth, or airway, seek medical attention immediately.
How long does an outbreak last?
Juvenile hemangiomas don't have outbreaks. They appear shortly after birth, grow rapidly for a period (proliferation phase), and then slowly shrink over time (involution phase). The involution phase can last for several years. Most hemangiomas will have significantly involuted by the time the child is 5-10 years old.
How is it diagnosed?
Clinical examination: Usually diagnosed based on its characteristic appearance and growth pattern.
Medical history: The doctor will ask about the baby's medical history and any family history of hemangiomas.
Imaging studies (rarely): In some cases, an ultrasound or MRI may be needed to evaluate the size, depth, and location of the hemangioma, especially if it is deep or causing functional problems.
Timeline of Symptoms
Birth to a few weeks: May be absent at birth or appear as a faint red patch.
1-6 months: Rapid growth (proliferation) phase.
6-12 months: Growth begins to slow.
1-10 years: Slow involution phase. The hemangioma gradually shrinks and lightens in color.
Important Considerations
Psychosocial Impact: Large or disfiguring hemangiomas can have a psychosocial impact on the child and family. Support and counseling may be helpful.
Location Matters: Hemangiomas near vital structures (eyes, nose, mouth, airway) require close monitoring and potentially early intervention.
Ulceration Management: Prompt treatment of ulceration is essential to prevent infection and minimize scarring.
Treatment Decisions: The decision to treat a hemangioma should be made on a case-by-case basis, considering the size, location, growth rate, and potential complications.
Long-Term Follow-up: Even after involution, some residual changes may persist, such as skin discoloration, texture changes, or telangiectasias (small visible blood vessels). Laser therapy or surgery may be considered to address these issues.