Capillary hemangioma

Synonym(s)

Strawberry hemangioma; strawberry mark; raspberry lesion; infantile hemangioma; capillary angioma

Definition

Benign vascular neoplasm, consisting of proliferating endothelial cells, with early proliferation, usually followed by spontaneous involution

Pathogenesis

May involve abnormal release of ang-iogenic factors; possible role of estrogens

Capsaicin 117

Clinical manifestation

Early lesion (up to 6 weeks of age): blanching of the involved skin; development of fine telangiectasias; formation of a red or violaceous macule or papule, often surrounded by a faint whitish halo Proliferative stage (up to 12 months): dome-shaped, multilobular papule or nodule; may develop central erosion or ulceration; firm, rubbery consistency; expands with increased intravascular pressure Involution stage: shrinks centrifugally from the center of the lesion; lesion becomes less red, with a dusky maroon to purple color; eventually regains normal flesh tones ("graying")

Cavernous variant: deep dermal and subcutaneous red-to-violaceous nodule; regression is often incomplete

Differential diagnosis

Nevus flammeus; blue rubber bleb nevus syndrome; Mafucci syndrome; angiosar-coma arteriovenous malformation; infantile fibrosarcoma; infantile myofibromato-sis; pseudo-Kaposi's hemangioendotheli-oma; lymphatic malformation; teratoma; Gorham syndrome; Riley-Smith syndrome

Therapy

Ulcerated hemangiomas and thin superficial hemangiomas - flash lamp-pumped pulsed dye laser; lesions compromising function (e.g. larynx or eyelid) - prednisolone 2-5 mg per kg per day PO

References

Richards KA, Garden JM (2000) The pulsed dye laser for cutaneous vascular and nonvascular lesions. Seminars in Cutaneous Medicine & Surgery 19(4^276-286

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