TY - JOUR
T1 - Clinical characteristics of infantile hemangiomas with aggressive, persistent, and destructive ulceration
AU - Gautam, Ayushi
AU - Frieden, Ilona J.
AU - Shah, Sonal D.
AU - Witman, Patricia M.
AU - Harfmann, Katya
AU - Bradley, Flora
AU - Blei, Francine
AU - Pope, Elena
AU - Alsumait, Anwar
AU - Gupta, Deepti
AU - Covelli, Isabela
AU - Streicher, Jenna L.
AU - Cotton, Colleen
AU - Tollefson, Megha
AU - Nguyen, Henry
AU - Hunt, Raegan
AU - Buros, Amy
AU - Fernández Faith, Esteban
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Background/Objectives: Ulceration is a common complication of infantile hemangioma (IH). Severe, persistent ulceration occurs in a minority of patients. This study aims to characterize the clinical features of IH with aggressive ulceration (AU). Methods: Multicenter retrospective study of clinical features of IH with AU. Results: Thirty-five patients with AU were identified and included in the study. The majority of AU occurred in segmental IH (23/35, 65%). Segmental IH with AU were large (≥10 cm2; 16/23, 69%, p <.001) with a thin (<3 mm) superficial component (16/23, 69%, p <.001). Localized IH with AU had a thick (>3 mm) superficial component (11/12, 92%, p <.001). All diaper area IH with AU (9/35) were segmental with thin superficial component (100%, p =.02). IH with AU in the head/neck (10/35) were more commonly localized (67%) and mixed (62.5%), while segmental, thick superficial morphology was more common on trunk (9/35) and upper extremities (7/35). Conclusions: IH resulting in AU differ in clinical features by anatomic site. Those in the diaper area are nearly always segmental with thin superficial component, whereas other sites tend to be localized, mixed, with thick superficial component. These distinct phenotypes may prove useful in the clinical setting for physicians to identify patterns of IH ulceration with increased risk of aggressive, persistent ulceration.
AB - Background/Objectives: Ulceration is a common complication of infantile hemangioma (IH). Severe, persistent ulceration occurs in a minority of patients. This study aims to characterize the clinical features of IH with aggressive ulceration (AU). Methods: Multicenter retrospective study of clinical features of IH with AU. Results: Thirty-five patients with AU were identified and included in the study. The majority of AU occurred in segmental IH (23/35, 65%). Segmental IH with AU were large (≥10 cm2; 16/23, 69%, p <.001) with a thin (<3 mm) superficial component (16/23, 69%, p <.001). Localized IH with AU had a thick (>3 mm) superficial component (11/12, 92%, p <.001). All diaper area IH with AU (9/35) were segmental with thin superficial component (100%, p =.02). IH with AU in the head/neck (10/35) were more commonly localized (67%) and mixed (62.5%), while segmental, thick superficial morphology was more common on trunk (9/35) and upper extremities (7/35). Conclusions: IH resulting in AU differ in clinical features by anatomic site. Those in the diaper area are nearly always segmental with thin superficial component, whereas other sites tend to be localized, mixed, with thick superficial component. These distinct phenotypes may prove useful in the clinical setting for physicians to identify patterns of IH ulceration with increased risk of aggressive, persistent ulceration.
KW - aggressive ulcerationhemangioma
KW - infantile hemangioma
KW - ulceration
KW - vascular anomalies
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U2 - 10.1111/pde.15444
DO - 10.1111/pde.15444
M3 - Article
C2 - 37845188
AN - SCOPUS:85174287394
SN - 0736-8046
VL - 40
SP - 996
EP - 1002
JO - Pediatric Dermatology
JF - Pediatric Dermatology
IS - 6
ER -