Haemangioma

Haemangioma

Develop within 3 months of birth (occasionally present at birth), proliferate rapidly for about a year, plateau and then start to involute. Treatment is necessary for the following reasons:

1. Bleeding
2. Obstruction of vital structure eg,
   • periorally; difficult feeding
   • periorbitally; obstruction of vision
   • perianally / perivulvally
3. Ulceration
4. Kasabach-Merritt syndrome
• sequestration of platelets within large hemangiomas
• consumptive coagulopathy
• bleeding
• low platelet count
• high-output cardiac failure
• disseminated intravascular coagulation
5. Cosmesis for psychological development of child

Refer to a dermatologist for consideration of laser treatment. Intralesional steroids or oral steroids are occasionally used. By 5yrs 50% have involuted, 70% by 7y, 90% by 9y. Some involute completely without any remnant but the majority leave some stigmata eg telangiectases, a fibrofatty residuum or atrophy.