Infantile hemangioma in Infant/Neonate
Usually, IHs are noticed at approximately 3 weeks of life. The initial proliferative phase usually lasts for about 1 year, with rapid growth during the first 6 months. This is followed by gradual involution over several years, with >90% completely involuting by age 10. Although IHs involute with time, residual skin changes persist in up to 30% of lesions after involution is complete.
For more information, see OMIM.
D18.01 – Hemangioma of skin and subcutaneous tissue
83343001 – Infantile hemangioma
- Congenital hemangioma (CH) – Fully formed vascular tumors at birth; two types are described: rapidly involuting congenital hemangiomas (RICH) and non-involuting congenital hemangiomas (NICH). The proliferative phase in these tumors occurs in utero, and tumors typically do not proliferate postnatally as seen with IHs. CHs are characterized by hemispheric pink to purple vascular plaques with overlying telangiectasia and the characteristic peripheral rim of pallor. Both RICH and NICH may look similar; however, NICH is less impressive and flatter. Histologically, they are GLUT-1 negative, which helps to differentiate them from other hemangiomas.
- Port-wine stain – Early lesions of hemangioma may be confused with port-wine stains, which are capillary malformations present at birth. They are pink or red patches that persist throughout life and do not have the typical growth phase of hemangiomas.
- Sometimes tufted angioma and kaposiform hemangioendothelioma may mimic hemangiomas. They present as extensive brownish vascular plaques with deep fibrotic consistency.
- Infantile myofibromatosis – Fibrohistiocytic proliferations characterized by skin-colored to purple, firm to hard or rubbery nodules that are usually present in the head and neck region.
- Rhabdomyosarcoma – Soft tissue sarcoma of skeletal muscle origin typically seen in the first and second decades of life. In children, the head and neck areas are affected with an asymptomatic, rapidly growing, reddish cutaneous mass.
- Deep hemangiomas sometimes look similar to venous malformations, which do not go through a phase of rapid proliferation. Phleboliths are often seen in venous malformations. Magnetic resonance (MR) imaging will help to differentiate these two entities.
- Venous malformation
- Lymphangioma circumscriptum
- Arteriovenous malformation