title: Differences between ulcerated and non-ulcerated hemangiomas, a retrospective study of 465 cases.
abstract: Our purpose was to get better insight into the ulceration of hemangiomas, by comparing patient characteristics of non-ulcerated hemangiomas with hemangiomas with active or past ulceration. A retrospective analysis was performed of files of patients who visited the Radboud University Medical Centre Nijmegen (UMCN), the Netherlands, between 1997 and 2007 for one or more infantile hemangiomas. The medical records of 465 patients were reviewed. Twenty three percent of the patients were diagnosed with ulceration. The size of ulcerated hemangiomas was significantly larger (28.6 cm2 vs. 6.0 cm2, p < 0.05). Predilection areas for ulceration were the head-neck region and the anogenital region. Ulceration was significantly most frequently seen in hemangiomas with a superficial (epidermal) component (98.5%, p < 0.05) and a segmental distribution (29.3%, p < 0.05). Ulceration most frequently took place during the proliferation phase of the hemangioma (83.1%). In the whole study population the male to female ratio was 1:2 compared to a tendency to more girls (1:3) for the group with ulcerated hemangiomas (p = 0.08). We conclude that larger, more superficial hemangiomas in areas more susceptible to trauma and contamination were more likely to ulcerate. This study contributes to the possibility of assessing the likelihood of ulceration in an individual patient.
authors.affiliation: Department of Dermatology Radboud University Medical Centre, René Descartesdreef 1, 6525 GC Nijmegen, The Netherlands.
authors.forename: Denise Josephina Johanna
authors.initials: DJ
authors.lastname: Hermans
authors.forename: Jan Bernardus Maria
authors.initials: JB
authors.lastname: Boezeman
authors.forename: Peter Cornelius Maria
authors.initials: PC
authors.lastname: Van de Kerkhof
authors.forename: Paul Nicolas Maria Antonius
authors.initials: PN
authors.lastname: Rieu
authors.forename: Carine Joanna Maria
authors.initials: CJ
authors.lastname: Van der Vleuten
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006391:Hemangioma / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000453:epidemiology / Q000473:pathology*