Infatile hemangiomas with minimal or arrested growth associated with soft tissue hypertrophy: a case series of 10 patients
Planas-Ciudad S (1), Roé Crespo E (1), Sánchez-Carpintero I (2), Frieden IJ (3), Martín-Santiago A (4), Redondo Bellón P (5), Moreno Artero E (5), Osier E (6), Puig Sanz L (1), Baselga Torres E (1).
(1) Dermatology department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
(2) Dermatology department, Clínica Dermatológica Internacional, Madrid, Spain.
(3) Dermatology department, University of California San Francisco Medical Center, San Francisco, United States.
(4) Dermatology department, Hospital Son Espases, Mallorca, Spain.
(5) Dermatology department, Clínica Universitaria de Navarra, Spain.
(6) Pediatric and Adolescent dermatology deparment, University of California at San Diego and Rady Children's Hospital, San Diego, California, United States.
Infantile hemangiomas with minimal or arrested growth (IH-MAGs) are characterized by a proliferative component of less than 25% of its surface area. The co-occurrence of IH-MAGs and soft tissue anomalies is rare and case series of this association are lacking.
We present ten cases of IH-MAGs associated with soft tissue hypertrophy and describe their clinical features.
We reviewed all infantile hemangiomas with minimal or arrested growth seen between 2009 to 2016 in the dermatology clinic department at Hospital Santa Creu i Sant Pau, Barcelona. To collect more patients, we also requested cases from the Hemangioma Investigator Group and members of the Spanish Society of Vascular Anomalies.
Ten patients had IH-MAGs associated with soft tissue hypertrophy; seven involving the arm and three involving the leg. All displayed a segmental pattern, a doughy and puffy texture, and prominent surface veins.
No significant asymmetries in limbs and no other visceral anomalies were observed at follow-up (range 15 months to 7 years). One patient reported coldness in the limb with infantile hemangioma, but RMI-angiography did not disclose a vascular malformation underneath the lesion.
Ulceration was observed in three patients. The proliferative component in all IH -MAGs had faded at one-year follow-up, while soft tissue hypertrophy and prominent vessels remained unchanged.
In this first case series of IH-MAGS associated with soft tissue hypertrophy Soft tissue hypertrophy was not progressive and remained unchanged over time, unlike the proliferative component of classic infantile hemangioma.
The origin of the prominent vessels and the higher ulceration risk are unknown; however, these findings are probably related to a minor disruption of local vessels not detected in imaging tests.
CITATION J Eur Acad Dermatol Venereol. 2017 Jul 5. doi: 10.1111/jdv.14457