Haemangioma of Infancy is a benign(not cancerous)overgrowth of blood vessels. It usually appears few days after birth, grows for few months and then tends to gradually reduce in size even if no treatment is done. It’s also called strawberry haemangioma as it may look like a strawberry.
The cause of haemangioma is not fully known. The cells lining blood vessels start to overgrow mostly soon after birth. It is more common in females, premature infants and twin/multiple pregnancies.
Haemangiomas usually do not run in families, but very rarely, they may be inherited.
Most of the haemangiomas appear on the head and neck area though other areas can also be affected. Usually a few days or a few
weeks after birth, haemangioma appears as a red spot which may increase over first few months of life. Usually growth after first three months is quite slow. Mostly, the growth stops after twelve months of age, after which most haemangiomas shrink. However, some of the haemangiomas may not grow much while some may not shrink as expected. During growing phase, the lesions look bright red in colour
and may resemble a strawberry. If the haemangioma is deeper, it may appear swollen and may have a bluish discoloration. Sometimes
the haemangioma can grow quite large, when it is called a segmental haemangioma, and it may be associated with other associated problems which may need investigations. Once haemangioma shrinks, it may disappear completely, or it may leave behind some residual blood vessels or area of loose skin.
Most haemangiomas usually disappear completely and do not cause any symptoms, not even persistent cosmetic issues. They may however look scary to parents, especially when they are enlarging. Some lesions may show breakdown of skin, especially those in nappy area, causing raw area. These may bleed intermittently and may be very painful, needing urgent attention. Haemangiomas near the nose may cause breathing difficulty, near the mouth may cause feeding difficulty while near the eye may cause vision problems. If there are more than five lesions, then they may be associated with similar lesions inside the body needing further investigations. Large haemangiomas and those overlying the spine may need investigations too.
Mostly, the diagnosis can be made just by the appearance of the lesion and in late phases by history of growth followed by slow regression. Ultrasound scans with Doppler can be used for confirmation if there is doubt or if one wants to know the extent of haemangioma. Very rarely, skin tissue or biopsy is needed.
Mostly, haemangiomas will gradually shrink and may even disappear completely on their own, while some may need treatment. Some would leave some mark or loose tissue which may need surgical correction.
Some haemangiomas need treatment because either they are likely to affect or already affecting vital function or have potential cosmetic concerns in the future. These include haemangiomas near eyes, mouth or nose causing issues with vision, feeding and breathing respectively. Lesions near mouth or anus may need active treatment as they have potential to breakdown and cause wounds. Large haemangiomas or those on face may need treatment due to potential future cosmetic concerns.
Small superficial haemangiomas can be treated by medications like timolol applied on the lesions. Larger lesions or ones growing rapidly are likely to need oral treatment like propranolol or steroids. Some hemangiomas, especially which have broken down causing raw areas, or which have shrunk but left behind some visible blood vessels, may need laser treatment. Residual loose tissue after the haemangioma has shrunk may need surgery. Propranolol treatment is usually started after admitting the infant to the hospital as it needs monitoring of some parameters like heart rate, blood pressure and blood sugar during treatment. Usually treatment is continued for at least up to one year of age when chances of haemangioma growing further are negligible. Haemangiomas with raw areas may need pain relief medications. Laser treatment in paediatric age group may need use of anaesthetic. Camouflage or make up may help in concealing the lesion.
Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.
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