Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 882-887 (doi:10.1542/peds.2006-0413)
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ARTICLE

Prospective Study of Infantile Hemangiomas: Clinical Characteristics Predicting Complications and Treatment

Anita N. Haggstrom, MDa, Beth A. Drolet, MDb, Eulalia Baselga, MDc, Sarah L. Chamlin, MDd, Maria C. Garzon, MDe, Kimberly A. Horii, MDf, Anne W. Lucky, MDg, Anthony J. Mancini, MDd, Denise W. Metry, MDh, Brandon Newell, MDf, Amy J. Nopper, MDf and Ilona J. Frieden, MDa

a Department of Dermatology, University of California, San Francisco, California
b Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
c Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
d Departments of Pediatrics and Dermatology, Northwestern University Feinberg School, of Medicine, Chicago, Illinois
e Departments of Dermatology and Pediatrics, Columbia University, New York, New York
f Section of Dermatology, Children's Mercy Hospital and Clinics, Kansas City, Missouri
g Division of Pediatric Dermatology and the Hemangioma and Vascular Malformation Center, Cincinnati Children's Hospital, Cincinnati, Ohio
h Department of Dermatology, Baylor College of Medicine, Houston, Texas

OBJECTIVES. Infantile hemangiomas are the most common tumor of infancy. Risk factors for complications and need for treatment have not been studied previously in a large prospective study. This study aims to identify clinical characteristics associated with complications and the need for therapeutic intervention.

PATIENTS AND METHODS. We conducted a prospective cohort study at 7 US pediatric dermatology clinics with a consecutive sample of 1058 children, aged ≤12 years, with infantile hemangiomas enrolled between September 2002 and October 2003. A standardized questionnaire was used to collect data on each patient and each hemangioma, including clinical characteristics, complications, and treatment.

RESULTS. Twenty-four percent of patients experienced complications related to their hemangioma(s), and 38% of our patients received some form of treatment during the study period. Hemangiomas that had complications and required treatment were larger and more likely to be located on the face. Segmental hemangiomas were 11 times more likely to experience complications and 8 times more likely to receive treatment than localized hemangiomas, even when controlled for size.

CONCLUSIONS. Large size, facial location, and/or segmental morphology are the most important predictors of poor short-term outcomes as measured by complication and treatment rates.

Key Words: dermatology • hemangioma • birthmark • infantile hemangioma

Abbreviations: IH—infantile hemangioma • CI—confidence interval • OR—odds ratio

Accepted Apr 10, 2006.




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