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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
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 is not intended to take the place of medical advice.
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Last updated: 22/07/2012