title: Surgical Management of Scalp Infantile Hemangiomas.
abstract: BACKGROUND
  Scalp infantile hemangiomas (IHs) are usually focal lesions that can be both disfiguring and may lead to complications such as ulceration and bleeding. The clinical features of scalp IHs have not been previously studied. This study aims to identify the clinical characteristics associated with scalp IH, the indications for surgical intervention, and results of surgical treatment.
  
  
  METHODS
  We performed a retrospective chart review of patients with scalp IH presenting to a tertiary care referral center over the past 7 years. Patients' demographics, clinical features, location, and treatment course were noted.
  
  
  RESULTS
  One hundred fifty-one of 1916 total IH patients presented with a diagnosis of scalp IH (8%). The distribution of the scalp lesions was the following: 31.8% frontal, 46.7% parietal, 7.9% occipital, and 9.9% temporal. Fifty-eight percent were solitary and 42% were multifocal lesions. The size range of scalp IH is 1 × 1 cm to 8 × 6 cm. Two percent of patients with scalp IH presented with other facial IH. Primary indications for surgery were secondary to complications such as ulceration (23.2%) and alopecia (51.7%). Surgery included elliptical excision with primary closure (85.7%) or with rotational flap closure (14.3%). The average age of surgery was 3 years (1-8 years). Most patients had a good aesthetic outcome with satisfactory hair growth.
  
  
  CONCLUSIONS
  Scalp IHs are morbid tumors which often cause alopecia and/or ulceration. In our experience, many scalp IHs eventually require surgical intervention. We find that early surgical excision is beneficial, as the tissues are easily manipulated secondary to scalp/soft tissue laxity and scarring is more favorable.
authors.affiliation: *Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea †Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals, New York, New York ‡Vascular Anomalies Program of Lenox Hill Hospital, Lenox Hill Hospital, New York, New York.
authors.forename: Young Kyoo
authors.initials: YK
authors.lastname: Cho
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Ryu
authors.forename: Ho Yun
authors.initials: HY
authors.lastname: Chung
authors.forename: Teresa M
authors.initials: TM
authors.lastname: O
authors.forename: Francine
authors.initials: F
authors.lastname: Blei
authors.forename: Milton
authors.initials: M
authors.lastname: Waner
mesh_terms: D005260:Female; D018324:Hemangioma, Capillary / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012535:Scalp / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps