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Infantile hemangiomas: risk factors for complications, recurrence and unaesthetic sequelae
Mariani, Letícia Gaertner; Ferreira, Lílian Moraes; Rovaris, Diego Luiz; Bonamigo, Renan Rangel; Kiszewski, Ana Elisa.
  • Mariani, Letícia Gaertner; Universidade Federal de Ciências da Saúde de Porto Alegre. Postgraduate Program in Pathology. Porto Alegre. BR
  • Ferreira, Lílian Moraes; Universidade Federal do Pampa. Faculty of Medicine. Uruguaiana. BR
  • Rovaris, Diego Luiz; Universidade de São Paulo. Instituto de Ciências Biomédicas. Department of Physiology and Biophysics. São Paulo. BR
  • Bonamigo, Renan Rangel; Universidade Federal do Rio Grande do Sul. Faculty of Medicine. Porto Alegre. BR
  • Kiszewski, Ana Elisa; Universidade Federal de Ciências da Saúde de Porto Alegre. Service of Dermatology, Santa Casa de Misericórdia de Porto Alegre. Porto Alegre. BR
An. bras. dermatol ; 97(1): 37-44, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360072
ABSTRACT
Abstract

Background:

Infantile hemangiomas (IH) occur in approximately 4% to 10% of the pediatric population. The identification of clinical subtypes and conditions that indicate increased risk for complications is essential for therapeutic success.

Objectives:

To identify risk factors for complications, recurrence and unaesthetic sequelae.

Methods:

Retrospective cohort of patients with infantile hemangiomas undergoing follow-up at the Dermatology Service of Universidade Federal de Ciências da Saúde de Porto Alegre, between 2006 and 2018.

Results:

190 patients were included; 24% had some type of complication, ulceration being the most frequent, and 86% required treatment. On correlation, ulceration was statistically related to mixed IH (p = 0.004), segmental IH (p < 0.01) and location in the gluteal region (p = 0.001). The mean time of treatment with propranolol was 12.7 months. Patients with PHACES syndrome and segmental infantile hemangioma required longer treatment (p < 0.001 and p = 0.0407, respectively), as well as those who started treatment after five months of life (p < 0.0001). Recurrence occurred in 16.6% of the treated patients, all-female; 94% were located on the head and neck (mainly on the upper eyelid, cyrano, S3 segment, and with parotid involvement); 61% and 38.8% were of the mixed and deep subtypes, respectively. Approximately 1/3 of the patients had some unaesthetic sequelae. Study

limitations:

As this is a retrospective study, data and photos of some patients were lost.

Conclusions:

Mixed and segmental hemangiomas are risk factors for ulceration and sequelae. Recurrence occurs more often in females and segmental hemangiomas. Segmental infantile hemangioma and PHACES syndrome require a longer time of treatment. Specific protocols are required for infantile hemangiomas with a high risk of recurrence.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Skin Neoplasms / Hemangioma Type of study: Etiology study / Practice guideline / Observational study / Prognostic study / Risk factors Limits: Child / Female / Humans / Infant Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Ciências da Saúde de Porto Alegre/BR / Universidade Federal do Pampa/BR / Universidade Federal do Rio Grande do Sul/BR / Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Skin Neoplasms / Hemangioma Type of study: Etiology study / Practice guideline / Observational study / Prognostic study / Risk factors Limits: Child / Female / Humans / Infant Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Ciências da Saúde de Porto Alegre/BR / Universidade Federal do Pampa/BR / Universidade Federal do Rio Grande do Sul/BR / Universidade de São Paulo/BR