title: The nasal crease sign in segmental facial hemangioma--an early sign of cartilage destruction.
abstract: Although the majority of hemangiomas of infancy do not require treatment, a subset of patients have complications such as ulceration, functional impairment or severe disfigurement that necessitate intervention. It is often difficult to predict which hemangiomas will lead to permanent disfigurement and medical complications. We present three patients with segmental facial hemangiomas involving the nose which resulted in nasal cartilage destruction. All three patients had a linear gray atrophic crease in the inferior columella visualized on clinical examination prior to the onset of nasal collapse. We propose that this ''nasal crease sign'' in infants with segmental facial hemangioma involving the nose and philtrum may be a premonitory clinical finding of impending nasal cartilage destruction. Dermatologists should be aware of this clinical sign which may help identify patients at high risk of nasal destruction. Unfortunately, aggressive medical intervention may not always prevent devastating disfigurement.
authors.affiliation: Division of Pediatric Dermatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Children's Memorial Hospital, Chicago, Illinois, USA.
authors.forename: Dakara R
authors.initials: DR
authors.lastname: Wright
authors.forename: Daniela C
authors.initials: DC
authors.lastname: Russi
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Mancini
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Chamlin
authors.forename: Annette M
authors.initials: AM
authors.lastname: Wagner
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D002356:Cartilage / Q000473:pathology*; D005260:Female; D006391:Hemangioma / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D009300:Nasal Septum / Q000473:pathology; D009336:Necrosis; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D011994:Recombinant Proteins
chemical_list: D020533:Angiogenesis Inhibitors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins