Treatment of cutaneous hemangioma

  Previously considered red birthmarks were collectively called hemangiomas. The new classification (developed in 1996 by the International Society for the Study of Angiomas and Vascular Malformations and recognized internationally) divides traditional hemangiomas into hemangiomas and vascular malformations. As the name implies, hemangiomas are true vascular tumors, while vascular malformations are those in which the affected child’s blood vessels are different from those of normal people. Common clinical types include infantile hemangioma, congenital hemangioma, and vivid nevus, all of which are benign lesions.  About the treatment of hemangioma The purpose of hemangioma treatment is to inhibit the proliferation of vascular endothelial cells, destroy blood vessels or reduce blood vessels, promote the fading of the tumor, reduce the residue of the tumor, or remove the malformed blood vessels to induce the disappearance of the hemangioma.  The methods of hemangioma treatment include laser treatment, drug treatment, surgery and photodynamic treatment.  (1) Laser treatment: Pulsed dye laser is the laser of choice for treating hemangioma, which is suitable for superficial hemangioma (bright red or red color to the naked eye or protruding from the skin surface), and other lasers include multi-frequency 532nm Nd:YAG laser, long pulse Nd:YAG laser, long pulse emerald laser, etc. Laser treatment is currently the ideal treatment modality due to its obvious efficacy and less side effects.  (2) Drug therapy: ① Systemic drug therapy: propranolol, hormone, etc., suitable for hemangioma with special location (such as around the eyes, nose, mouth, airway side, etc.), large area (such as the whole head and face or trunk or extremities or multiple parts, etc.) and high risk.  (2) Local drug treatment: local topical drugs including propranolol ointment, timolol eye drops or timolol gel are suitable for superficially located hemangiomas; local drug injection treatment including pindamycin, hormone, etc. are suitable for deeper and thicker located hemangiomas.  (3) Surgical treatment: Non-surgical treatment such as oral propranolol, local topical drugs, pulsed dye laser and other treatments still have residual hemangioma, which can be surgically removed to improve aesthetics or restore limb activities, etc.  (4) Photodynamic therapy: A new type of treatment method suitable for the treatment of vivid nevus. The treatment principle is that after the photosensitizer is injected into human body through vein, it mainly gathers in the parts where hemangioma is distributed, and under the irradiation of specific wavelength of light, a large amount of active oxygen will be generated, which can lead to necrosis of proliferated blood vessels, and then the necrotic blood vessels will be removed by the body to achieve the treatment purpose.