HEMANGIOMA (CONGENITAL)

Congenital hemangioma’s are benign tumours of blood vessels which
become manifest in the first few days of life. They can be single or multiple
and vary in size from less than 1 cm to more than 10 cm. The preferred
site is the face though they can occur anywhere on the skin. The
mucous membranes i.e. the lip and tongue can be affected.
Hemangioma’s may grow rapidly in the first months causing great concern
to the parents. However, they regress spontaneously in about 70%
of the patients. Regression starts in the first year of life and takes 5-10
years. Sometimes a hemangioma may bleed easily or it may become
(partly) necrotic after trauma or during a period of fast regression.
Regression may show no scarring, there may be a slack, baggy area of
skin if the hemangioma was large or the skin may be hypopigmented and
atrophic.
Management of congenital hemangioma
- In most cases no treatment should be given. The parents need to be told that
spontaneous regression is to be expected and that this gives the best cosmetic
outcome. This is in contrast to surgery which may leave disfiguring scars.
Treatment is indicated in:
1 a lesion which does not disappear or gets bigger in a child > 7 years of age,
2 impaired function of vital organs, e.g. vision (by large lesions in the orbital region
or on the eyelid), hearing, breathing,
3 bleeding and/or ulcerating lesions.
Refer to a skin specialist or paediatrician for treatment. In some cases
intralesional steroids may be tried.