White Areas in Hemangiomas Point to Ulceration

Early white discoloration in infantile hemangiomas predicts ulceration with high sensitivity

FRIDAY, Nov. 19 (HealthDay News) -- In patients with infantile hemangiomas (IHs), early white discoloration predicts ulceration with high sensitivity, according to research published in the November issue of the Archives of Dermatology.

Sheilagh M. Maguiness, M.D., of Children's Hospital Boston, and colleagues analyzed data from 11 infants with early white discoloration of hemangiomas and extensive ulceration, as well as 55 3-month-old patients with IHs who were followed retrospectively through photographs.

The researchers found that, among the 11 patients, average age at first ulceration was 2.6 months, and average age at healing was 5.2 months. Among the other 55 patients, 12 of 14 with white discoloration (86 percent) had ulceration or developed it later. With white or slightly white hemangiomas, the sensitivity and specificity for predicting ulceration were 1.00 and 0.68, respectively.

"Ulceration is the most common complication and occurs most often toward the end of the growth phase: mean age at onset, 4 months. However, in some IHs, ulceration precedes proliferation and is actually the presenting clinical sign of IH. That ulceration can occur before tumor growth suggests that it may not simply be a response to rapid growth or tensile stress on the overlying skin but that other causes such as local tissue hypoxia may play a role," write the authors of an accompanying editorial.

Two co-authors disclosed financial relationships with Cutera Lasers or Pierre Fabre, and one author disclosed legal consulting.

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