What are the treatment options for hemangioma?

There are many treatment methods for infantile hemangioma, and appropriate treatment methods should be chosen according to the specific conditions. The most commonly used treatment methods: clinical observation, surgery, hormone, topical drugs, laser, freezing, sclerosing agent, etc. 1. Clinical observation: observe, wait and follow up regularly, explain the natural course of hemangioma to family members, preferably show them photos of other patients to further explain the process of hemangioma regression, and explain to them that the effect of natural regression is better than the result of any other active treatment. Major indications: infantile hemangiomas in the regressive or late regressive phase; proliferative infantile hemangiomas that are small, in areas less prone to complications, and growing slowly; and rapidly regressing congenital hemangiomas (RICH). The typical presentation is a purplish-blue, elevated tumor with distended veins; or an elevated gray tumor with surface capillary dilation and a white ring of surrounding vasoconstriction; or a relatively flat, infiltrative growth with purplish-blue surface skin.RICH varies in size and in most cases is only a few centimeters in diameter. The surface skin temperature is slightly elevated, and murmurs and palpable tremors can occasionally be heard. Unlike infantile hemangiomas, RICH does not have a rapid growth phase after birth, but rather regresses rapidly, completely resolving within 12-18 months. Another so-called benign neonatal hemangiomatosis also presents as multiple hemangiomas throughout the body, but is not combined with visceral hemangiomas. Neonatal hemangioma can mostly subside before the age of 2 years; parents have certain knowledge of infant hemangioma and they have a very high likelihood of the treatment effect and subside of infant hemangioma. 2.Surgical treatment: The possibility that the hemangioma can subside and the psychological tolerance of the child to the surgical scar should be fully considered before surgery. Main indications: hemangioma located in trunk and limbs, with hidden scar after surgery, and family members have psychological ability to bear the scar after surgery; infant and young children’s hemangioma that is likely to produce or has produced complications; hemangioma with limited body, outward growth, with tip, and skin changes that may remain after receding; eyelid hemangioma with ulcer formation, bleeding, ineffective to other non-surgical treatment methods and ineffective to drug treatment; congenital hemangioma that cannot be receded. The typical clinical presentation is round or oval, slightly protruding from the skin, pale in the center or periphery, and with dilated capillaries on the surface. The diameter varies from a few to a dozen centimeters, with an average size of 5M. The skin temperature was slightly elevated, and ultrasound Doppler was able to detect rapid arterial blood flow. The pathology is characterized by a lobular distribution of cells with stellate vessels surrounding the central vessel, with predominantly abnormally developed veins between the lobules, and negative GLUT-1 immunohistochemistry expression. nich never subsides. 3. Indications for treatment with prednisone and prednisolone hormone: periorbital hemangiomas; airway hemangiomas are mostly located under the vocal cords and may be combined with cutaneous hemangiomas. 60% of large stage hemangiomas involving the face and neck are complicated by airway hemangiomas; neonatal multiple hemangiomas are clinically rare and are characterized by multiple cutaneous hemangiomas accompanied by visceral hemangiomas. Clinical manifestations are pinpoint to soybean-sized, bright red, multiple hemangiomas that may have formed at birth or in the weeks after birth; hepatic hemangiomas may present with increased arteriovenous flow to the liver (by ultrasonography), cardiac hypertrophy, and tachycardia before causing congestive heart failure. 4.Pingyangmycin treatment: facial hemangioma affects the patient’s appearance and is not suitable for surgical removal and will seriously affect the appearance after surgical removal; hemangioma with characteristics of infantile embryonic vascular endothelium; deep infantile hemangioma invades deep dermis and subcutaneous tissue, epidermis maintains normal thickness, the surface of tumor is light blue or normal skin color, capillary expansion is visible on the surface and reflux veins are visible around; other methods of treatment are ineffective The tumor surface is blue or normal skin color, capillary dilation is visible on the surface and the surrounding reflux veins are visible. 5. Imiquimod is an immunomodulator, and in recent years, there are scattered reports in the literature on the efficacy of topical imiquimod in the treatment of infantile hemangioma, mainly for superficial infantile hemangioma (so-called strawberry hemangioma) which only invades the dermis and manifests as lobulated, bright red red spots. Toxic side effects are very rare. 6.Laser treatment: Several kinds of lasers have been used for the treatment of hemangioma. Since 1990, pulsed fuel laser (PDL) has been used in clinical practice. Most of the literature reports that PDL is suitable for the treatment of superficial hemangiomas and residual erythema after the hemangioma has subsided. Treatment is given once every 2-3 weeks until the hemangioma is controlled. PDL is not suitable for the treatment of deep hemangiomas because of its limited penetration ability and inability to reach deeper areas. The Nd-YAG laser is also effective in treating hemangiomas, but there is a risk of ulceration and scarring.