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Multiple Cutaneous Infantile Hemangioma and the Risk of Internal Hemangioma

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Practical Pediatric Dermatology

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Abstract

Infantile hemangioma (IH) is a frequently occurring tumor in infancy of which the pathogenesis is not completely understood. Although IHs are self-limiting, they can cause problems during their active growth and therapy may then be indicated. Generally, screening for internal hemangiomas is recommended when five or more cutaneous IHs are present. This recommendation, however, is lacking solid scientific evidence. In this chapter, we discuss some controversies regarding the prevalence of IH, the nomenclature of “hemangiomas,” the nomenclature of multiple hemangiomas/hemangiomatosis, the therapy of IH, and the abovementioned screening recommendation. Since 1993, children with IHs have been evaluated in outpatient consultations by the working group on vascular anomalies Rotterdam (WEVAR), using an approach protocol. This protocol aimed at determining the relation between number of IHs and the occurrence of internal hemangiomas. We included all patients presenting with five or more cutaneous IHs in the period of 1993–2011. These patients had all been referred for an ultrasound study for internal hemangiomas. We distinguished between children with ten or more IHs (hemangiomatosis group, group 1) and children with five to nine IHs (multiple IH group, group 2). Forty-three patients were included, 27 in group 1 and 16 in group 2. Nine infants in the hemangiomatosis group 1 showed internal hemangiomas versus none in group 2. Further examination for internal hemangiomas in children with fewer than ten cutaneous IHs is controversial and does not seem to be necessary. However, we do recommend ultrasound examination for children with ten or more cutaneous IHs.

Astrid D Vredenborg and Sherief R Janmohamed are both first author

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Acknowledgment

We thank Ko Hagoort for the language revision.

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Authors and Affiliations

  1. Department of Dermatology, Catharina Hospital, Eindhoven, The Netherlands

    Astrid D. Vredenborg MD, MSc

  2. Department of Dermatology, University Hospital Brussels, Brussels, Belgium

    Sherief R. Janmohamed MD, PhD, MHS, MSc

  3. Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands

    Peter C. J. de Laat MD, PhD

  4. Department of Pediatric Surgery, Erasmus MC, Rotterdam, The Netherlands

    Gerard C. Madern MD, MSc

  5. Department of Dermatology, Dermicis Skin Hospital – Alkmaar, Kinderhuid.nl – Rotterdam, Rotterdam, The Netherlands

    Arnold P. Oranje MD, PhD

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  1. Astrid D. Vredenborg MD, MSc
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  2. Sherief R. Janmohamed MD, PhD, MHS, MSc
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  3. Peter C. J. de Laat MD, PhD
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  4. Gerard C. Madern MD, MSc
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  5. Arnold P. Oranje MD, PhD
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Correspondence to Arnold P. Oranje MD, PhD .

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Editors and Affiliations

  1. Rotterdam, The Netherlands

    Arnold P. Oranje

  2. Farwaniya, Kuwait

    Nawaf Al-Mutairi

  3. Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA

    Tor Shwayder

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Vredenborg, A.D., Janmohamed, S.R., de Laat, P.C.J., Madern, G.C., Oranje, A.P. (2016). Multiple Cutaneous Infantile Hemangioma and the Risk of Internal Hemangioma. In: Oranje, A., Al-Mutairi, N., Shwayder, T. (eds) Practical Pediatric Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-32159-2_9

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  • DOI: https://doi.org/10.1007/978-3-319-32159-2_9

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