TABLE 2

Definitions

Hemangioma specialist:Unlike many diseases, management of IHs is not limited to 1 medical or surgical specialty. A hemangioma specialist may have expertise in dermatology, hematologyoncology, pediatrics, facial plastic and reconstructive surgery, ophthalmology, otolaryngology, pediatric surgery, and/or plastic surgery, and his or her practice is often focused primarily or exclusively on the pediatric age group.
Hemangioma specialists should:• understand the time-sensitive nature of IHs during the growth phase and be able to accommodate requests for urgent evaluation;
• have experience with accurate risk stratification and potential complications associated with IHs;
• be able to provide recommendations for various management options, including observation, medical therapies, and surgical or laser procedures, and provide counseling regarding the potential risks and benefits of these interventions for specific patients; and
• have a thorough knowledge of past and emerging medical literature regarding IHs.
• Such specialists often have 1 or more of the following characteristics:
 ○ participated in a vascular anomalies program during previous medical training;
 ○ devotes a significant part of his or her clinical practice to IHs;
 ○ is a member of or collaborates with a multidisciplinary vascular anomalies center;
 ○ maintains membership in professional organizations or groups with a special interest in IHs;
 ○ participates in research studies in the field of IHs; or
 ○ publishes medical literature in the field of IHs.
IHs: infantile hemangiomasBenign vascular tumors of infancy and childhood with unique clinical and histopathologic characteristics that distinguish them from other vascular tumors (eg, congenital hemangiomas) or malformations. These characteristics include development during the first weeks or months of life, a typical natural history of rapid growth followed by gradual involution, and immunohistochemical staining of biopsy specimens with erythrocyte-type glucose transporter protein and other unique markers not present on other benign vascular tumors. Many other entities are also called hemangiomas. Some are true vascular tumors, and others are vascular malformations. Therefore, it is important to use the adjective “infantile” when referring to true IHs. IHs are classified on the basis of soft-tissue depth and the pattern of anatomic involvement (see Supplemental Figs 5–10 for photographic examples).
 Soft-tissue depth:• Superficial: red with little or no evidence of a subcutaneous component (formerly called strawberry” hemangiomas);
• Deep: blue and located below the skin surface (formerly called “cavernous” hemangiomas); and
• Combined (mixed): both superficial and deep components are present.
 Anatomic appearance:• Localized: well-defined focal lesions (appearing to arise from a central point);
• Segmental: IH involving an anatomic region that is often plaque-like and often measuring at >5 cm in diameter;
• Indeterminate (undetermined): neither clearly localized or segmental (often called partial segmental); and
• Multifocal: multiple discrete IHs at disparate sites.