Localized infantile hemangiomas of the face and scalp: Predilection for the midline and periorbital and perioral skin

Anita Haggstrom, Eulalia Baselga, Sarah L. Chamlin, Beth A. Drolet, Maria C. Garzon, Kristen E. Holland, Kimberly A. Horii, Christine Lauren, Anne Lucky, Anthony J. Mancini, Erin Mathes, Catherine C. McCuaig, Kimberly Morel, Brandon Newell, Elena Pope, Julie Powell, Kate Puttgen, Sahand Rahnama-Moghadam, Wei Song, Ilona J. Frieden

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/Objectives: Infantile hemangiomas are common vascular tumors. Identifying sites of predilection may provide insight into pathogenesis. Previous studies have suggested a predilection for the boundary of facial metameres. The objective was to observe patterns of localized hemangiomas on the face and scalp, determine sites of predilection, and place these patterns in a developmental context. Methods: A retrospective review of photographic archives at 10 Hemangioma Investigator Group pediatric dermatology centers identified localized infantile hemangiomas of the face and scalp. Heat map software was used to identify areas of predilection. Dot maps were used to assess frequency, and densities of infantile hemangiomas were compared between facial units using t-testing. The scalp was divided into quintiles to assess relative frequencies. Results: Four thousand one hundred fifty-three focal face and scalp infantile hemangiomas were mapped, of which 2962 (71%) were mapped to a frontal facial template. On the face, 73.8% (2186/2962) of hemangiomas occurred along the midline axis or perpendicularly across the ocular axis in a cross-shaped area of predilection intersecting at the glabella. Scalp hemangiomas show a predilection for the midline, with 149/295 (50.5%) noted on the top of the scalp at the midline (P < 0.001). Localized hemangiomas do not demonstrate a preferential laterality. Conclusion: The distribution of localized infantile hemangiomas of the face and scalp is not random. There is preferential involvement of the midline face and scalp and the ocular axis. The regions corresponding to the boundaries between the embryonic facial segments, including the maxillary and mandibular metameres, are not accentuated in the distribution of infantile hemangiomas.

Original languageEnglish (US)
JournalPediatric Dermatology
DOIs
StateAccepted/In press - Jan 1 2018

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Hemangioma
Scalp
Skin
Dermatology
Blood Vessels
Software
Hot Temperature
Research Personnel
Pediatrics

Keywords

  • developmental defects
  • hemangiomas

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dermatology

Cite this

Localized infantile hemangiomas of the face and scalp : Predilection for the midline and periorbital and perioral skin. / Haggstrom, Anita; Baselga, Eulalia; Chamlin, Sarah L.; Drolet, Beth A.; Garzon, Maria C.; Holland, Kristen E.; Horii, Kimberly A.; Lauren, Christine; Lucky, Anne; Mancini, Anthony J.; Mathes, Erin; McCuaig, Catherine C.; Morel, Kimberly; Newell, Brandon; Pope, Elena; Powell, Julie; Puttgen, Kate; Rahnama-Moghadam, Sahand; Song, Wei; Frieden, Ilona J.

In: Pediatric Dermatology, 01.01.2018.

Research output: Contribution to journalArticle

Haggstrom, A, Baselga, E, Chamlin, SL, Drolet, BA, Garzon, MC, Holland, KE, Horii, KA, Lauren, C, Lucky, A, Mancini, AJ, Mathes, E, McCuaig, CC, Morel, K, Newell, B, Pope, E, Powell, J, Puttgen, K, Rahnama-Moghadam, S, Song, W & Frieden, IJ 2018, 'Localized infantile hemangiomas of the face and scalp: Predilection for the midline and periorbital and perioral skin', Pediatric Dermatology. https://doi.org/10.1111/pde.13626
Haggstrom, Anita ; Baselga, Eulalia ; Chamlin, Sarah L. ; Drolet, Beth A. ; Garzon, Maria C. ; Holland, Kristen E. ; Horii, Kimberly A. ; Lauren, Christine ; Lucky, Anne ; Mancini, Anthony J. ; Mathes, Erin ; McCuaig, Catherine C. ; Morel, Kimberly ; Newell, Brandon ; Pope, Elena ; Powell, Julie ; Puttgen, Kate ; Rahnama-Moghadam, Sahand ; Song, Wei ; Frieden, Ilona J. / Localized infantile hemangiomas of the face and scalp : Predilection for the midline and periorbital and perioral skin. In: Pediatric Dermatology. 2018.
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title = "Localized infantile hemangiomas of the face and scalp: Predilection for the midline and periorbital and perioral skin",
abstract = "Background/Objectives: Infantile hemangiomas are common vascular tumors. Identifying sites of predilection may provide insight into pathogenesis. Previous studies have suggested a predilection for the boundary of facial metameres. The objective was to observe patterns of localized hemangiomas on the face and scalp, determine sites of predilection, and place these patterns in a developmental context. Methods: A retrospective review of photographic archives at 10 Hemangioma Investigator Group pediatric dermatology centers identified localized infantile hemangiomas of the face and scalp. Heat map software was used to identify areas of predilection. Dot maps were used to assess frequency, and densities of infantile hemangiomas were compared between facial units using t-testing. The scalp was divided into quintiles to assess relative frequencies. Results: Four thousand one hundred fifty-three focal face and scalp infantile hemangiomas were mapped, of which 2962 (71{\%}) were mapped to a frontal facial template. On the face, 73.8{\%} (2186/2962) of hemangiomas occurred along the midline axis or perpendicularly across the ocular axis in a cross-shaped area of predilection intersecting at the glabella. Scalp hemangiomas show a predilection for the midline, with 149/295 (50.5{\%}) noted on the top of the scalp at the midline (P < 0.001). Localized hemangiomas do not demonstrate a preferential laterality. Conclusion: The distribution of localized infantile hemangiomas of the face and scalp is not random. There is preferential involvement of the midline face and scalp and the ocular axis. The regions corresponding to the boundaries between the embryonic facial segments, including the maxillary and mandibular metameres, are not accentuated in the distribution of infantile hemangiomas.",
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author = "Anita Haggstrom and Eulalia Baselga and Chamlin, {Sarah L.} and Drolet, {Beth A.} and Garzon, {Maria C.} and Holland, {Kristen E.} and Horii, {Kimberly A.} and Christine Lauren and Anne Lucky and Mancini, {Anthony J.} and Erin Mathes and McCuaig, {Catherine C.} and Kimberly Morel and Brandon Newell and Elena Pope and Julie Powell and Kate Puttgen and Sahand Rahnama-Moghadam and Wei Song and Frieden, {Ilona J.}",
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T1 - Localized infantile hemangiomas of the face and scalp

T2 - Predilection for the midline and periorbital and perioral skin

AU - Haggstrom, Anita

AU - Baselga, Eulalia

AU - Chamlin, Sarah L.

AU - Drolet, Beth A.

AU - Garzon, Maria C.

AU - Holland, Kristen E.

AU - Horii, Kimberly A.

AU - Lauren, Christine

AU - Lucky, Anne

AU - Mancini, Anthony J.

AU - Mathes, Erin

AU - McCuaig, Catherine C.

AU - Morel, Kimberly

AU - Newell, Brandon

AU - Pope, Elena

AU - Powell, Julie

AU - Puttgen, Kate

AU - Rahnama-Moghadam, Sahand

AU - Song, Wei

AU - Frieden, Ilona J.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background/Objectives: Infantile hemangiomas are common vascular tumors. Identifying sites of predilection may provide insight into pathogenesis. Previous studies have suggested a predilection for the boundary of facial metameres. The objective was to observe patterns of localized hemangiomas on the face and scalp, determine sites of predilection, and place these patterns in a developmental context. Methods: A retrospective review of photographic archives at 10 Hemangioma Investigator Group pediatric dermatology centers identified localized infantile hemangiomas of the face and scalp. Heat map software was used to identify areas of predilection. Dot maps were used to assess frequency, and densities of infantile hemangiomas were compared between facial units using t-testing. The scalp was divided into quintiles to assess relative frequencies. Results: Four thousand one hundred fifty-three focal face and scalp infantile hemangiomas were mapped, of which 2962 (71%) were mapped to a frontal facial template. On the face, 73.8% (2186/2962) of hemangiomas occurred along the midline axis or perpendicularly across the ocular axis in a cross-shaped area of predilection intersecting at the glabella. Scalp hemangiomas show a predilection for the midline, with 149/295 (50.5%) noted on the top of the scalp at the midline (P < 0.001). Localized hemangiomas do not demonstrate a preferential laterality. Conclusion: The distribution of localized infantile hemangiomas of the face and scalp is not random. There is preferential involvement of the midline face and scalp and the ocular axis. The regions corresponding to the boundaries between the embryonic facial segments, including the maxillary and mandibular metameres, are not accentuated in the distribution of infantile hemangiomas.

AB - Background/Objectives: Infantile hemangiomas are common vascular tumors. Identifying sites of predilection may provide insight into pathogenesis. Previous studies have suggested a predilection for the boundary of facial metameres. The objective was to observe patterns of localized hemangiomas on the face and scalp, determine sites of predilection, and place these patterns in a developmental context. Methods: A retrospective review of photographic archives at 10 Hemangioma Investigator Group pediatric dermatology centers identified localized infantile hemangiomas of the face and scalp. Heat map software was used to identify areas of predilection. Dot maps were used to assess frequency, and densities of infantile hemangiomas were compared between facial units using t-testing. The scalp was divided into quintiles to assess relative frequencies. Results: Four thousand one hundred fifty-three focal face and scalp infantile hemangiomas were mapped, of which 2962 (71%) were mapped to a frontal facial template. On the face, 73.8% (2186/2962) of hemangiomas occurred along the midline axis or perpendicularly across the ocular axis in a cross-shaped area of predilection intersecting at the glabella. Scalp hemangiomas show a predilection for the midline, with 149/295 (50.5%) noted on the top of the scalp at the midline (P < 0.001). Localized hemangiomas do not demonstrate a preferential laterality. Conclusion: The distribution of localized infantile hemangiomas of the face and scalp is not random. There is preferential involvement of the midline face and scalp and the ocular axis. The regions corresponding to the boundaries between the embryonic facial segments, including the maxillary and mandibular metameres, are not accentuated in the distribution of infantile hemangiomas.

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KW - hemangiomas

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