Infantile Haemangiomas: a Dermatologist's Perspective
Authors:
R. Faberová 1; P. Arenberger 2; Š. Čapková 3; S. Polášková 4; J. Štěrba 5; J. Vokurková 6; D. Prusíková 2; H. Bučková 1
Authors‘ workplace:
Dětské kožní oddělení Pediatrické kliniky FN Brno a LF MU, Brno
přednosta prof. MUDr. Zdeněk Doležel, CSc.
1; Dermatovenerologická klinika 3. LF UK a FN Královské Vinohrady, Praha
přednosta prof. MUDr. Petr Arenberger, Dr. Sc., MBA
2; Dermatologické oddělení pro děti, FN Motol Praha
primářka MUDr. Štěpánka Čapková
3; Poliklinika VFN Karlovo náměstí, Dětská kožní ambulance Dermatovenerologické kliniky 1. LF UK a VFN, Praha
přednosta prof. MUDr. Jiří Štork, CSc.
4; Klinika dětské onkologie FN Brno a LF MU, Brno
přednosta prof. MUDr. Jaroslav Štěrba, Ph. D.
5; Oddělení plastické chirurgie KDCHOT FN Brno a LF MU, Brno
přednosta prof. MUDr. Ladislav Plánka, Ph. D.
6
Published in:
Čes-slov Derm, 92, 2017, No. 5, p. 206-218
Category:
Reviews (Continuing Medical Education)
Overview
Infantile hemangiomas (IH) are the most common benign tumors affecting 10–12% of infants with increased incidence in premature and immature female babies. There are three basic types – superficial, deep and mixed. Infantile hemangiomas are the result of vasculogenesis and angiogenesis dysregulation. IH differ in number, size and depth of skin and subcutaneous tissue invasion. Most hemangiomas (90%) do not require treatment, involution lasting several years occurs after intense growth phase in the first 5 to 6 months of life. In extensive segmental and deep hemagiomas growth activity persists even in the 2nd and 3rd year of life. Approximately 10 % of IH might cause serious complications. Treatment choice is individual and requires comprehensive approach. The choice is the non-selective betablocker propranolol administered at a dose of 2–3mg/kg/day for 6–7 months. Propranolol acts as a vasoconstrictor of IH capillaries, blocks vascular endothelial growth factor (VEGF) promoting vascular development and induces apoptosis (natural death of vascular cells). Treatment has to be performed in centres with experienced pediatric dermatologist, oncologist, cardiologist, radiologist and plastic surgeon. Propranolol treatment is reimbursed in 4 centres in the Czech Republic (Faculty Hospitals in Motol, Královské Vinohrady, Brno and Ostrava).
Key words:
infantile hemangiomas – epidemiology – pathogenesis – differential diagnosis – therapy
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2017 Issue 5
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