Infantile hemangiomas are a type of mark found on the skin of approximately 10 percent of infants. Unlike some other types of skin markings, infantile hemangiomas are not present at birth but rather they typically begin growing in the days and weeks following delivery.
Typically, parents will report that an area of skin first turns red, and within weeks a raised, red patch develops that is noticeably different from the surrounding skin. As weeks progress, the red plaque may continue to grow and may deepen in color to purple or blue. These patches can occur on any part of the body and can vary in size from very small (a few millimeters) to fairly large (more than a few centimeters). They are more common in girls than boys.
The hemangioma will feel soft to the touch and should not cause the infant any pain. A typical hemangioma will grow fastest in the first two months of life and will finish enlarging by the fifth month of life. They then begin a slow process of involution, or going away. On average, 50 percent of all hemangiomas resolve by age four, and 95 percent are gone by adolescence. Smaller ones leave very small marks to indicate where they were before disappearing. Larger hemangiomas may leave faint blood vessels, called telangiectasias, or a change in the skin where it was located.
In many cases, nothing needs to be done to hasten the resolution of the hemangioma. In certain locations, such as when the hemangioma is near the eyes, medication is prescribed to slow the growth and promote the involution of the mark. In rare cases, a hemangioma can interfere with a vital organ. In those circumstances, surgery would be necessary.
A pediatrician is often comfortable diagnosing and monitoring a small hemangioma such as one on a limb or the trunk. For infants who have multiple hemangiomas, very large hemangiomas, or lesions around the eyes, airway, scalp, or genitals, consultation with a pediatric dermatologist is a good idea. Pediatric dermatologists are trained to recognize unusual types of hemangiomas and recommend treatment.
- Atlas of Pediatric Physical Diagnosis, Zitelli and Davis; 2002; Chapter 8:pp
Pediatric Dermatology, fourth ed
- Cohen, MD; Chapter 2
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