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Hemangioma

(Infantile Hemangioma; Superficial Hemangioma; Deep [or Cavernous] Hemangioma; Strawberry Hemangioma; Strawberry Mark)

Definition

A hemangioma is a type of birthmark. It develops shortly after birth, usually on the head or neck. It may be close to the surface of the skin or deeper below the skin.
For most, a hemangioma will grow quickly and then slowly disappear over time. It is often gone before puberty. If your child develops a birthmark that grows, talk to a doctor. Hemangiomas may need medical treatment.

Causes

A hemangioma is a cluster of blood vessels do not that form normally. It is not known what cause hemangiomas. It is also unclear on what makes them grow, or disappear.

Risk Factors

Factors that increase a baby's chance of a hemangioma include:
  • Being female
  • Caucasian
  • Premature birth

Symptoms

Symptoms will depend on the location of the hemangioma:
  • A hemangioma that is close to the surface of the skin will:
    • Appear as red "strawberry" or purple bump on the skin
    • may continue to grow and spread
  • A hemangioma the is deeper under the skin will appear as bluish swelling under the skin.
Most hemangiomas have no further symptoms. However, some large hemangiomas may lead to:
  • Ulceration—deep sores in the skin
  • Scarring
  • Disfigurement
  • Problems with growth and function of structures nearby such as eyes or airway
  • Abnormalities of the blood vessels of the eye or brain, as well as heart problems (associated with some hemangiomas of the face)

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Some hemangiomas are obvious with physical exam. If there is any question, your doctor may recommend testing. Tests may also be done to determine the size and effect on local organs.
Tests that can make a picture of the hemangioma and surrounding structures include:

Treatment

Most hemangiomas will resolve on their own. The mark will significantly fade by age five and nearly disappear by puberty. Your doctor may only recommend monitoring during the growth period.
If the hemangioma is causing problems your doctor may recommend one of the following treatments:
  • Medication such as steroids, propranolol, or vincristine
  • Surgery—particularly for hemangiomas that are causing pain or problems with sight or breathing
  • Lasers—most effective on superficial hemangiomas
If ulcers have developed more aggressive treatment may be needed. It may require a combination of treatments above.

Prevention

There is no way to prevent hemangiomas.

RESOURCES

American Academy of Dermatology http://www.aad.org

Vascular Birthmarks Foundation http://www.birthmark.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

Sturge-Weber Syndrome Community Canada (SWSCC) http://swscommunitycanada.org

References

Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol . 2003;48:477-493.

Burton BK, Schulz CJ, Angle B, et al. An increased incidence of haemangiomas in infants born following chorionic villus sampling (CVS). Prenat Diagn . 1995;15:209-214.

Haggstrom AN, Frieden, IJ. Hemangiomas: Past, present, and future. J Am Acad Dermatol . 2004;51: S50-52.

Hemangioma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated December 23, 2011. Accessed November 12, 2012.

10/25/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Haggstrom AN, Garzon MC, Baselga E, et al. Risk for PHACE syndrome in infants with large facial hemangiomas. Pediatrics. 2010;126(2):e418-426.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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