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.
Division of Pediatric Dermatology, Children's Memorial Hospital and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Sarah L
SL
Chamlin
Anita N
AN
Haggstrom
Beth A
BA
Drolet
Eulalia
E
Baselga
Ilona J
IJ
Frieden
Maria C
MC
Garzon
Kimberly A
KA
Horii
Anne W
AW
Lucky
Denise W
DW
Metry
Brandon
B
Newell
Amy Jo
AJ
Nopper
Anthony J
AJ
Mancini
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