title: Retrospective Study of Nasal Infantile Hemangiomas: Characteristics, Complications, and Outcomes.
abstract: OBJECTIVE
  Nasal infantile hemangiomas (IHs) pose serious medical complications and psychosocial stress if tumor involution is incomplete or prolonged. The objective was to determine which IH characteristics are associated with complications and are predictive of outcome, assessed as the presence of IHs or residual skin changes upon kindergarten entry, to better manage these lesions and counsel families.
  
  
  METHODS
  A retrospective chart review of all patients seen in the Division of Pediatric Dermatology at Johns Hopkins Medicine between 2001 and 2014 for nasal IHs (N = 89) was performed. A follow-up telephone interview with parents was conducted in June and July 2014.
  
  
  RESULTS
  Complications were observed in 39% of patients. Segmental and indeterminate IHs were more likely to have complications than focal IHs (p = 0.01). Mixed IHs were more likely to ulcerate than deep or superficial IHs (p = 0.01). Eighty percent of patients had treatment and 19% had surgery. Although IHs regressed by kindergarten entry in 70% of patients, 78% of these patients had residual skin changes. Mixed and superficial IHs left more residua than deep IHs (p = 0.04). A statistical comparison of treatments with respect to outcome at kindergarten entry could not be made because subgroups were too small and heterogeneous.
  
  
  CONCLUSIONS
  Nasal IHs had higher rates of complications and treatment than previous reports of IHs at all body sites. Lesions of segmental and indeterminate type and mixed depth should be identified as high risk and treated accordingly. Parents may be counseled that most nasal IHs involute by kindergarten but leave residua and that early referral for treatment may be important for the best outcome.
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Maria S
authors.initials: MS
authors.lastname: Kryatova
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.|Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Rainer
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jiawei
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Vadim A
authors.initials: VA
authors.lastname: Villarroel
authors.affiliation: School of Medicine and Health Sciences, George Washington University, Children's National Health System, Washington, DC.
authors.forename: Anna
authors.initials: A
authors.lastname: Yasmine Kirkorian
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Grossberg
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Puttgen
authors.affiliation: Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Cohen
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma; D018324:Hemangioma, Capillary / Q000150:complications / Q000473:pathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy