Biomechanical properties of infantile hemangiomas: clinical stage and effect of age.
BACKGROUND
Infantile hemangiomas (IHs) are benign vascular neoplasms with rapid capillary proliferation shortly after birth and slow involution with diminishing capillary proliferative activity, fibrosis, and fatty replacement over 7-10 years.


METHODS
Hemangiomas and contralateral control sites in 88 subjects were measured using a suction device, 6-mm probe and 200 mbar negative pressure. Mechanical properties were assessed vs. controls and effects of body site, depth, clinical stage, histology diagnosis, and time.


RESULTS
Biological elasticity, overall elasticity, net elasticity, total recovery, and elastic recovery were lower for IH vs. controls (P < 0.001). IH total deformation, elastic deformation, viscoelastic creep, and residual deformation were higher than controls (P < 0.001). Involuting IHs had lower viscoelasticity than proliferating and stable lesions (P < 0.001) and lower viscoelastic creep than stable IHs (P = 0.04). IH viscoelasticity was higher at 2.3 than 12.9, 23.7, and 61.0 months and at 4.9 and 8.1 than 61.0 months. IH elastic recovery varied by body site with larger differences vs. control for abdomen and leg. Elastic recovery differences from control were smaller at younger vs. older ages.


CONCLUSIONS
Measurement of biomechanical properties may be useful to characterize IH progression and treatment response in clinical settings.
Skin Sciences Program, Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. marty.visscher@gmail.com.|Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. marty.visscher@gmail.com.
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Visscher
Skin Sciences Program, Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
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Burkes
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA.
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Adams
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Hemangioma and Vascular Malformation Center, Cincinnati, OH, USA.
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Gupta
James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
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Wickett
D000375:Aging; D002648:Child; D002675:Child, Preschool; D055119:Elastic Modulus; D005260:Female; D006244:Hardness; D006391:Hemangioma / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology* / Q000503:physiopathology*; D015595:Skin Aging / Q000473:pathology*; D014783:Viscosity
biomechanical properties; deformation; elastic recovery; elasticity; infant; infantile hemangioma; objective measurement; ontogeny; skin