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Strawberry Hemangiomas
| • | at birth the major cutaneous vasculature is already formed, but the microvasculature continues to reorganize for the first four months of life |
| • | the proliferative phase of hemangioma neoplasms coincides with the postnatal period of reorganization |
treatment:
| • | prednisone (2mg/kg/day) often long course (8 to 10 months) (slow taper to avoid rebound) |
| • | interferon alpha (adverse effect = spastic diplegia) |
| • | ulcerating – Regranex gel Qam (under dressing or barrier cream); metrogel Qpm (healing ≈ 21days) |
| • | ILK 10 to 20/cc (small volumes) |
NEONATAL HEMANGIOMATOSIS
| • | AKA Diffuse Congenital Hemangiomatosis |
| • | sporadic; multiple 0.2cm – 2cm hemangiomas |
| • | visceral involvement varies form none to disseminated; most commonly involves the liver (64%) |
| • | widespread visceral involvement may lead to death by high-output cardiac failure |
| • | lesions begin to involute in second half of first year of life (90% have involuted by age 9) |
| • | treatment: PO steroid, interferon-alpha (but 10% incidence of spastic diplegia) |
see Kasabach-Merritt Phenomenon
Cavernous Hemangioma
| • | two rare conditions in which numerous cavernous hemangiomas occur (both sporadic): |
Maffucci syndrome
| • | sporadic; pathogenesis unknown |
| • | enchondromas (= benign cartilaginous tumors): |
| • | may develop into chondrosarcomas |
| • | numerous cavernous hemangiomas (esp. distal extremities) |
| • | ddx: Proteus syndrome, blue rubber bleb nevus syndrome |
blue rubber bleb nevus syndrome
| • | sporadic; pathogenesis unknown |
| • | cavernous hemangiomas of skin and GI tract |
| • | GI bleeding and anemia, therefore CBC, stool guiacs, endoscopy |
| • | ddx: Maffucci syndrome, multiple glomus tumors, diffuse congenital Hemangiomatosis |
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