title: The "biker-glove" pattern of segmental infantile hemangiomas on the hands and feet.
abstract: BACKGROUND
  Infantile hemangiomas (IH) on the extremities have not been systematically studied.
  
  
  OBJECTIVE
  We sought to describe the clinical characteristics and distribution patterns of IH affecting acral surfaces and to explore the relationship among these patterns, limb development, and IH pathogenesis.
  
  
  METHODS
  This was a retrospective multicenter cohort study. Photographic archives from 4 tertiary pediatric dermatology referral centers were searched for patients with IH larger than 1 cm and involving 1 or more digit. Hemangioma location, distribution, and morphologic subtype were recorded. Medical records were reviewed for demographic and clinical data.
  
  
  RESULTS
  In all, 73 patients were identified. The most common IH pattern resembled that of a "biker glove" (73%), followed by localized IH on the distal digits (14%), segmental IH extending over the distal digits (8%), and intermediate patterns (5%). Overall, 63% of acral IH were segmental, 26% indeterminate, and 11% localized. Five patients had associated structural anomalies. Complications were noted in 33% of cases.
  
  
  CONCLUSIONS
  Limitations were retrospective study design; selection bias based on recall and photography; documentation and follow-up were not standardized across institutions; and treatment information may not reflect current approaches.
  
  
  CONCLUSIONS
  Acral IH display specific patterns and are associated with a relatively high risk of ulceration.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Weitz
authors.affiliation: Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Bayer
authors.affiliation: Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Eulalia
authors.initials: E
authors.lastname: Baselga
authors.affiliation: Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Torres
authors.affiliation: Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Dawn
authors.initials: D
authors.lastname: Siegel
authors.affiliation: Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Drolet
authors.affiliation: Department of Dermatology, University of California, San Francisco, California; Department of Pediatrics, University of California, San Francisco, California.
authors.forename: Ilona J
authors.initials: IJ
authors.lastname: Frieden
authors.affiliation: Department of Dermatology and Pediatrics, Indiana University, Indianapolis, Indiana. Electronic address: ahaggstr@iu.edu.
authors.forename: Anita N
authors.initials: AN
authors.lastname: Haggstrom
mesh_terms: D005260:Female; D005528:Foot; D006225:Hand; D006391:Hemangioma / Q000150:complications / Q000151:congenital / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D015983:Selection Bias; D012883:Skin Ulcer / Q000150:complications
keywords: acral; embryology; foot; hand; hemangioma; hypoxia; pathogenesis