Growth characteristics of infantile hemangiomas

Implications for management

Linda C. Chang, Anita Haggstrom, Beth A. Drolet, Eulalia Baselga, Sarah L. Chamlin, Maria C. Garzon, Kimberly A. Horii, Anne W. Lucky, Anthony J. Mancini, Denise W. Metry, Amy J. Nopper, Ilona J. Frieden

Research output: Contribution to journalArticle

373 Citations (Scopus)

Abstract

OBJECTIVES. Infantile hemangiomas often are inapparent at birth and have a period of rapid growth during early infancy followed by gradual involution. More precise information on growth could help predict short-term outcomes and make decisions about when referral or intervention, if needed, should be initiated. The objective of this study was to describe growth characteristics of infantile hemangioma and compare growth with infantile hemangioma referral patterns. METHODS. A prospective cohort study involving 7 tertiary care pediatric dermatology practices was conducted. Growth data were available for a subset of 526 infantile hemangiomas in 433 patients from a cohort study of 1096 children. Inclusion criteria were age younger than 18 months at time of enrollment and presence of at least 1 infantile hemangioma. Growth stage and rate were compared with clinical characteristics and timing of referrals. RESULTS. Eighty percent of hemangioma size was reached during the early proliferative stage at a mean age of 3 months. Differences in growth between hemangioma subtypes included that deep hemangiomas tend to grow later and longer than superficial hemangiomas and that segmental hemangiomas tended to exhibit more continued growth after 3 months of age. The mean age of first visit was 5 months. Factors that predicted need for follow-up included ongoing proliferation, larger size, deep component, and segmental and indeterminate morphologic subtypes. CONCLUSIONS. Most infantile hemangioma growth occurs before 5 months, yet 5 months was also the mean age at first visit to a specialist. Recognition of growth characteristics and factors that predict the need for follow-up could help aid in clinical decision-making. The first few weeks to months of life are a critical time in hemangioma growth. Infants with hemangiomas need close observation during this period, and those who need specialty care should be referred and seen as early as possible within this critical growth period.

Original languageEnglish
Pages (from-to)360-367
Number of pages8
JournalPediatrics
Volume122
Issue number2
DOIs
StatePublished - Aug 2008

Fingerprint

Hemangioma
Growth
Referral and Consultation
Cohort Studies
Tertiary Healthcare
Dermatology
Intercellular Signaling Peptides and Proteins
Observation
Parturition
Prospective Studies
Pediatrics

Keywords

  • Hemang oma/complications
  • Hemang oma/growth
  • Hemang oma/therapy
  • Hemangioma/prognosis
  • Infant
  • Infant-newborn
  • Skin neoplasms/growth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Chang, L. C., Haggstrom, A., Drolet, B. A., Baselga, E., Chamlin, S. L., Garzon, M. C., ... Frieden, I. J. (2008). Growth characteristics of infantile hemangiomas: Implications for management. Pediatrics, 122(2), 360-367. https://doi.org/10.1542/peds.2007-2767

Growth characteristics of infantile hemangiomas : Implications for management. / Chang, Linda C.; Haggstrom, Anita; Drolet, Beth A.; Baselga, Eulalia; Chamlin, Sarah L.; Garzon, Maria C.; Horii, Kimberly A.; Lucky, Anne W.; Mancini, Anthony J.; Metry, Denise W.; Nopper, Amy J.; Frieden, Ilona J.

In: Pediatrics, Vol. 122, No. 2, 08.2008, p. 360-367.

Research output: Contribution to journalArticle

Chang, LC, Haggstrom, A, Drolet, BA, Baselga, E, Chamlin, SL, Garzon, MC, Horii, KA, Lucky, AW, Mancini, AJ, Metry, DW, Nopper, AJ & Frieden, IJ 2008, 'Growth characteristics of infantile hemangiomas: Implications for management', Pediatrics, vol. 122, no. 2, pp. 360-367. https://doi.org/10.1542/peds.2007-2767
Chang, Linda C. ; Haggstrom, Anita ; Drolet, Beth A. ; Baselga, Eulalia ; Chamlin, Sarah L. ; Garzon, Maria C. ; Horii, Kimberly A. ; Lucky, Anne W. ; Mancini, Anthony J. ; Metry, Denise W. ; Nopper, Amy J. ; Frieden, Ilona J. / Growth characteristics of infantile hemangiomas : Implications for management. In: Pediatrics. 2008 ; Vol. 122, No. 2. pp. 360-367.
@article{18a50f1d62354163b248723a6f834d7a,
title = "Growth characteristics of infantile hemangiomas: Implications for management",
abstract = "OBJECTIVES. Infantile hemangiomas often are inapparent at birth and have a period of rapid growth during early infancy followed by gradual involution. More precise information on growth could help predict short-term outcomes and make decisions about when referral or intervention, if needed, should be initiated. The objective of this study was to describe growth characteristics of infantile hemangioma and compare growth with infantile hemangioma referral patterns. METHODS. A prospective cohort study involving 7 tertiary care pediatric dermatology practices was conducted. Growth data were available for a subset of 526 infantile hemangiomas in 433 patients from a cohort study of 1096 children. Inclusion criteria were age younger than 18 months at time of enrollment and presence of at least 1 infantile hemangioma. Growth stage and rate were compared with clinical characteristics and timing of referrals. RESULTS. Eighty percent of hemangioma size was reached during the early proliferative stage at a mean age of 3 months. Differences in growth between hemangioma subtypes included that deep hemangiomas tend to grow later and longer than superficial hemangiomas and that segmental hemangiomas tended to exhibit more continued growth after 3 months of age. The mean age of first visit was 5 months. Factors that predicted need for follow-up included ongoing proliferation, larger size, deep component, and segmental and indeterminate morphologic subtypes. CONCLUSIONS. Most infantile hemangioma growth occurs before 5 months, yet 5 months was also the mean age at first visit to a specialist. Recognition of growth characteristics and factors that predict the need for follow-up could help aid in clinical decision-making. The first few weeks to months of life are a critical time in hemangioma growth. Infants with hemangiomas need close observation during this period, and those who need specialty care should be referred and seen as early as possible within this critical growth period.",
keywords = "Hemang oma/complications, Hemang oma/growth, Hemang oma/therapy, Hemangioma/prognosis, Infant, Infant-newborn, Skin neoplasms/growth",
author = "Chang, {Linda C.} and Anita Haggstrom and Drolet, {Beth A.} and Eulalia Baselga and Chamlin, {Sarah L.} and Garzon, {Maria C.} and Horii, {Kimberly A.} and Lucky, {Anne W.} and Mancini, {Anthony J.} and Metry, {Denise W.} and Nopper, {Amy J.} and Frieden, {Ilona J.}",
year = "2008",
month = "8",
doi = "10.1542/peds.2007-2767",
language = "English",
volume = "122",
pages = "360--367",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "2",

}

TY - JOUR

T1 - Growth characteristics of infantile hemangiomas

T2 - Implications for management

AU - Chang, Linda C.

AU - Haggstrom, Anita

AU - Drolet, Beth A.

AU - Baselga, Eulalia

AU - Chamlin, Sarah L.

AU - Garzon, Maria C.

AU - Horii, Kimberly A.

AU - Lucky, Anne W.

AU - Mancini, Anthony J.

AU - Metry, Denise W.

AU - Nopper, Amy J.

AU - Frieden, Ilona J.

PY - 2008/8

Y1 - 2008/8

N2 - OBJECTIVES. Infantile hemangiomas often are inapparent at birth and have a period of rapid growth during early infancy followed by gradual involution. More precise information on growth could help predict short-term outcomes and make decisions about when referral or intervention, if needed, should be initiated. The objective of this study was to describe growth characteristics of infantile hemangioma and compare growth with infantile hemangioma referral patterns. METHODS. A prospective cohort study involving 7 tertiary care pediatric dermatology practices was conducted. Growth data were available for a subset of 526 infantile hemangiomas in 433 patients from a cohort study of 1096 children. Inclusion criteria were age younger than 18 months at time of enrollment and presence of at least 1 infantile hemangioma. Growth stage and rate were compared with clinical characteristics and timing of referrals. RESULTS. Eighty percent of hemangioma size was reached during the early proliferative stage at a mean age of 3 months. Differences in growth between hemangioma subtypes included that deep hemangiomas tend to grow later and longer than superficial hemangiomas and that segmental hemangiomas tended to exhibit more continued growth after 3 months of age. The mean age of first visit was 5 months. Factors that predicted need for follow-up included ongoing proliferation, larger size, deep component, and segmental and indeterminate morphologic subtypes. CONCLUSIONS. Most infantile hemangioma growth occurs before 5 months, yet 5 months was also the mean age at first visit to a specialist. Recognition of growth characteristics and factors that predict the need for follow-up could help aid in clinical decision-making. The first few weeks to months of life are a critical time in hemangioma growth. Infants with hemangiomas need close observation during this period, and those who need specialty care should be referred and seen as early as possible within this critical growth period.

AB - OBJECTIVES. Infantile hemangiomas often are inapparent at birth and have a period of rapid growth during early infancy followed by gradual involution. More precise information on growth could help predict short-term outcomes and make decisions about when referral or intervention, if needed, should be initiated. The objective of this study was to describe growth characteristics of infantile hemangioma and compare growth with infantile hemangioma referral patterns. METHODS. A prospective cohort study involving 7 tertiary care pediatric dermatology practices was conducted. Growth data were available for a subset of 526 infantile hemangiomas in 433 patients from a cohort study of 1096 children. Inclusion criteria were age younger than 18 months at time of enrollment and presence of at least 1 infantile hemangioma. Growth stage and rate were compared with clinical characteristics and timing of referrals. RESULTS. Eighty percent of hemangioma size was reached during the early proliferative stage at a mean age of 3 months. Differences in growth between hemangioma subtypes included that deep hemangiomas tend to grow later and longer than superficial hemangiomas and that segmental hemangiomas tended to exhibit more continued growth after 3 months of age. The mean age of first visit was 5 months. Factors that predicted need for follow-up included ongoing proliferation, larger size, deep component, and segmental and indeterminate morphologic subtypes. CONCLUSIONS. Most infantile hemangioma growth occurs before 5 months, yet 5 months was also the mean age at first visit to a specialist. Recognition of growth characteristics and factors that predict the need for follow-up could help aid in clinical decision-making. The first few weeks to months of life are a critical time in hemangioma growth. Infants with hemangiomas need close observation during this period, and those who need specialty care should be referred and seen as early as possible within this critical growth period.

KW - Hemang oma/complications

KW - Hemang oma/growth

KW - Hemang oma/therapy

KW - Hemangioma/prognosis

KW - Infant

KW - Infant-newborn

KW - Skin neoplasms/growth

UR - http://www.scopus.com/inward/record.url?scp=49849100961&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49849100961&partnerID=8YFLogxK

U2 - 10.1542/peds.2007-2767

DO - 10.1542/peds.2007-2767

M3 - Article

VL - 122

SP - 360

EP - 367

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 2

ER -