Strawberry Hemangioma

December 1, 2007

Photo A shows a red, slightly raised, 1 3 2-cm lesion on the left buttock of a 3-month-old boy. The lesion had been present since birth and had enlarged as the child grew. Photo B shows a similar lesion in the vulva of a 2-month-old girl that also had been present since birth; the mother stated that it had not enlarged.

Photo A shows a red, slightly raised, 1 3 2-cm lesion on the left buttock of a 3-month-old boy. The lesion had been present since birth and had enlarged as the child grew. Photo B shows a similar lesion in the vulva of a 2-month-old girl that also had been present since birth; the mother stated that it had not enlarged.

Both lesions are superficial capillary hemangiomas, which were diagnosed based on their clinical appearance and history. Hemangiomas present at birth or within the first 2 weeks of life in 1% to 3% of all infants.1 The lesions result from rapid proliferation of capillaries, venules, and arterioles. The pathogenesis is unknown. Superficial lesions are red (thus the name "strawberry" hemangiomas). "Deep" or "cavernous" hemangiomas involve the reticular dermis or subcutaneous fat and are blue or colorless.

Superficial hemangiomas are usually single. Multiple cutaneous hemangiomas are seen in 15% to 20% of patients and may be a marker for visceral involvement.1 The lesions usually develop on the face but may arise in any area. Most are small. They proliferate for the first 1 to 2 years of life, then regress and become fibrotic over the next several years; 30% resolve completely by 3 years of age, 50% by 5 years, and 70% by 7 years.1 After involution, the skin appears virtually normal in most patients, although scarring, atrophy, telangiectasia, or pigmentation can occur.

For most small hemangiomas in anatomic locations that are covered by clothing or hair, no treatment is required. However, because these lesions are susceptible to trauma and may bleed easily, a pressure dressing and antibiotic ointment are often used as needed.

Facial hemangiomas and lesions that cause functional impairment, such as those in the mouth, airway, or perianal region, may require active intervention. Options include oral or intralesional corticosteroids, interferon alfa 2b, laser therapy, topical imiquimod, and surgery. *

References:

REFERENCE:

1.

Habif TP.

Clinical Dermatology: A Color Guide to Diagnosis and Therapy.

4th ed. St Louis: Mosby; 2004:814-817.