Late growth of infantile hemangiomas in children >3 years of age: A retrospective study

J Am Acad Dermatol. 2019 Feb;80(2):493-499. doi: 10.1016/j.jaad.2018.07.061. Epub 2018 Oct 5.

Abstract

Background: The proliferative phase of infantile hemangiomas (IHs) is usually complete by 9 months of life. Late growth beyond age 3 years is rarely reported.

Objective: To describe the demographic and clinic characteristics of a cohort of patients with late growth of IH, defined as growth in a patient >3 years of age.

Methods: A multicenter, retrospective cohort study.

Results: In total, 59 patients, 85% of which were female, met the inclusion criteria. The mean first episode of late growth was 4.3 (range 3-8.5) years. Head and neck location (55/59; 93%) and presence of deep hemangioma (52/59; 88%) were common characteristics. Posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects, eye abnormalities (PHACE) syndrome was noted in 20 of 38 (53%) children with segmental facial IH. Systemic therapy (corticosteroid or β-blocker) was given during infancy in 58 of 59 (98%) and 24 of 59 (41%) received systemic therapy (β-blockers) for late IH growth.

Limitations: The retrospective nature and ascertainment by investigator recall are limitations of the study.

Conclusion: Late IH growth can occur in children after 3 years of age. Risk factors include head and neck location, segmental morphology, and involvement of deep dermal/subcutaneous tissues.

Keywords: corticosteroid; growth hormone; infantile hemangioma; late growth; segmental morphology; β-blocker.

Publication types

  • Multicenter Study

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Age Factors
  • Child
  • Child, Preschool
  • Cohort Studies
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hemangioma, Capillary / congenital
  • Hemangioma, Capillary / diagnosis*
  • Hemangioma, Capillary / therapy*
  • Humans
  • Laser Therapy / methods
  • Male
  • Propranolol / therapeutic use
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Skin Neoplasms / congenital
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / therapy*
  • Time Factors
  • Treatment Outcome
  • United States

Substances

  • Adrenal Cortex Hormones
  • Propranolol