Multicenter prospective study of ulcerated hemangiomas.
OBJECTIVE
To identify clinical features of infants with ulcerated infantile hemangiomas.


METHODS
Cross-sectional analysis was conducted within a prospective cohort study of children with infantile hemangiomas. Children younger than 12 years of age were recruited. Demographic and prenatal/perinatal information was collected. Hemangioma size, location, subtype, course, complications, and treatments were recorded.


RESULTS
One thousand ninety-six patients were enrolled, and 173 (15.8%) patients experienced ulceration. Ulceration occurred in 192 (9.8%) of 1960 [corrected] total hemangiomas. Hemangiomas with ulcerations were more likely large, mixed clinical type, segmental morphologic type, and located on the lower lip, neck, or anogenital region. Ulceration occurred at a median age of 4 months, most often during the proliferative phase. Children with ulcerated hemangiomas were more likely to present to a pediatric dermatologist at a younger age and to require treatment. Bleeding occurred in 41% of ulcerated lesions but was rarely of clinical significance. Infection occurred in 16%.


CONCLUSIONS
Ulceration occurs in nearly 16% of patients with infantile hemangiomas, most often by 4 months of age, during the proliferative phase. Location, size, and clinical and morphologic type are associated with an increased risk for development of ulceration.
Chamlin
Sarah L
SL
Division of Pediatric Dermatology, Children's Memorial Hospital and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Haggstrom
Anita N
AN
Drolet
Beth A
BA
Baselga
Eulalia
E
Frieden
Ilona J
IJ
Garzon
Maria C
MC
Horii
Kimberly A
KA
Lucky
Anne W
AW
Metry
Denise W
DW
Newell
Brandon
B
Nopper
Amy Jo
AJ
Mancini
Anthony J
AJ
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D014456:Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy