ABSTRACT
References 473
Hemangiomas are common benign vascular lesion of childhood that enlarge rapidly by
cellular proliferation and then involute. Rapid proliferation is a hallmark of hemangiomas
and helps to differentiate these birthmarks from other vascular malformations such as port-
wine stains, venous malformations, arterio-venous malformations, and lymphatic malfor-
mations (1). After about 1 year, hemangiomas undergo a slow regression that takes
between 2 and 10 years. Involution is not always complete and 50% of patients may be left with residual telangiectasias, epidermal atrophy, and redundant fibrofatty tissue
(2,3). Hemangiomas are further classified by their depth with respect to skin and the
extent of their involvement (4,5). Superficial hemangiomas comprise a cutaneous com-
ponent that presents as a bright-red vascular papule or plaque when fully developed
(Fig. 22.1). Deep hemangiomas have only a subcutaneous component without the super-
ficial red plaque. They appear as a bluish-colored nodule within the skin (Fig. 22.2).
Compound hemangiomas have both a superficial and a deep component (Fig. 22.3).
Hemangiomas may also be focal or diffuse (5). Focal lesions present as solitary masses
and appear to occur along lines of embryological fusion (Fig. 22.4). Eighty-five percent
of lesions are focal. On the other hand, diffuse lesions are segmental in distribution.
They present as superficial or compound plaque-like lesions and exhibit a high incidence
of ulceration (Fig. 22.5).
