Infantile Hemangiomas: Complications and Follow-Up.

Objective: To study the risk factors for hemangioma-related complications, treatment indications and analyze the outcome of patients with infantile hemangioma. Design: Retrospective. Setting: University hospital. Patients: Fifty-five patients (1-69 months; median: 12 months) with infantile hemangioma with mean follow-up 19 months. The eligibility was based on the criteria of the International Society for the Study of Vascular Anomalies (ISSVA). Intervention: The surgical treatment included total excision whereas medical treatment was carried out by interferon and /or corticosteroids. Main outcome measures: Data was collected including sex, age, prematurity, age at onset, number, anatomic location and size of hemangioma, age at treatment, cause of treatment decision, family history, presence of extra malformations, involvement of internal organs, presence of life altering or life threatening complications, response to treatment, dose and duration of medications, complications associated with treatment, follow-up period, and final outcome. Results: Thirty-four (62%) patients were followed-up without treatment, whereas 21 others underwent treatment including steroids, interferon, and surgery. The size of hemangioma was a major factor that predicted hemangioma-related complications (P=0.002). Patients with hemangioma related complications had bigger lesions (size ≥40cm2 or the longest size on a single plane ≥5 cm). Nineteen patients (34%) had complications, but only 8 (14.5%) out of them had life or function-threatening complications. Conclusion: Although dosing and treatment protocol is still debatable, steroids and interferon are good options for hemangioma treatment. The management strategy should be individualized for each case.

Effective treatment with hydroxychloroquine in a case of annular elastolytic giant cell granuloma.

Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous and elastolytic skin disease of unknown pathogenesis. Therapy for AEGCG is controversial. The data about the effectiveness of chloroquine in the treatment of AEGCG are also variable. Here, we report a case of AEGCG with significant improvement after a total treatment period of 22 weeks with hydroxychloroquine. Although a possibility of spontaneous remission cannot be ruled out, we think that chloroquine can be considered as an effective treatment of this chronic disorder.