Early treatment vital for infantile hemangiomas

By Helen Albert, Senior MedWire Reporter

US research shows that infantile hemangiomas, otherwise known as "strawberry" birthmarks, grow faster and earlier than previously believed.

Megha Tollefson (Mayo Clinic, Rochester, Minnesota) and colleagues found that the most rapid growth period for these benign but disfiguring tumors occurs between 5.5 and 7.5 weeks of age.

The team says their results suggest that infants with hemangiomas should be referred to a dermatologist as soon as possible, preferably before 4 weeks of age, so that appropriate drug treatment or surgical removal can be carried out at the earliest opportunity to prevent permanent disfigurement of the face or functional compromise of vital organs.

"Our goal was to try to figure out when this actual period of rapid growth happened," Tollefson commented in a press statement. "Then we could potentially intervene if we had to."

For the purposes of this study, serial images of 30 infants with hemangiomas were taken at intervals of 1-2 weeks for a period of 6 months. They were analyzed for color, thickness, and distortion of anatomic landmarks.

Notably, in addition to the earlier than expected tumor growth phase observed by the researchers, Tollefson and team found that cutaneous precursors of hemangiomas were present in 65% of the children at birth.

The results are in contrast to previously held beliefs that these tumors grow gradually through the first 5 months of life, say the investigators.

"Our findings suggest a need for a paradigm shift in the timing of referral and initiation of treatment of high-risk infantile hemangiomas so that therapy can be initiated before or early in the course of most rapid growth, rather than after it is already completed," write the authors in Pediatrics.

"Depending on where the hemangioma is located, it could potentially have long-term impact," Tollefson commented. "We now have the possibility of preventing a lot of that," she said.

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