Strawberry haemangioma /

Strawberry haemagioma

01 What Do I Need To Know?

  • Risk factors: fair skin, females, family history, prematurity, low birth weight, infants born to mothers with placental anomalies, and products of multiple gestations

Phases

Proliferation Phase

Occurs during the first year of life

 Lesion usually not present at birth but develop within the first 3 months of life

 Lesion grows during this phase

Growth slows or stops towards the end of this phase

 Involutional Phase

Occurs over a period of 5-7 years

50% involute by age 5, 70% involute by age 7

It takes an additional 3-5 years to complete process of involution

May have permanent, residual cutaneous effects (scars, telangiectasia, redundant skin, etc.)

TREATMENT

 Systemic Propranolol, first described in 2008

Mechanism of Action

Early Phase: Vasoconstriction

Intermediate Phase: Blocks intracellular signaling pathways

Long-term: Inhibit angiogenesis and/or triggers apoptosis of capillary endothelial cells

Has been shown to shrink lesions 

Dosage: 2 mg/kg/day Length of treatment guided by clinical improvement

Toxicities: bradycardia, hypotension, hypoglycemia

Topical Timolol

Dosage: 2 drops BID or timolol gel BID

Small study of 7 children reported 55-95% reduction in hemangioma size and volume and decrease in astigmatism

Effectiveness depends on the size, depth and thickness of the lesion

Best for localized, superficial lesions

Toxicities: similar to systemic propranolol

 

02 Clinicians Tools and Resources

  • Elena Pope, MD, FRCPC; Ajith Chakkittakandiyil, MD
  • Pediatr Dermatol. 2012 Jan-Feb;29(1):28-31

Timolol maleate 0.5% or 0.1% gel-forming solution for infantile hemangiomas: a retrospective, multicenter, cohort study.

Chakkittakandiyil A, Phillips R, Frieden IJ, Siegfried E, Lara-Corrales I, Lam J, Bergmann J, Bekhor P, Poorsattar S, Pope E.: Department of Dermatology, Hospital for Sick Children, Toronto, Canada.

 

The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
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Last updated: 22/07/2012