Talking about hemangioma

The most common “hemangioma”, which used to be called “strawberry hemangioma”, has been renamed as “infantile hemangiomas (IHs)”. “This disease is the most common benign tumor in infancy and early childhood, which is an embryonic benign tumor characterized by the proliferation of vascular endothelial cells, resembling a fresh strawberry, hence the old name “strawberry hemangioma”. Morbidity and clinical characteristics: The morbidity rate is lower in people of color than in Caucasians, and is lower than in Caucasians but higher than in Blacks, with a male to female morbidity rate of about 1:3. The risk of morbidity is significantly higher in premature and small children or children with multiple pregnancies. The disease affects the head, face and neck, followed by the extremities and trunk. The natural course of the disease can be divided into three stages: the proliferative stage, the receding stage and the completed receding stage, and because of its unique natural cycle, the receding rate has been reported to be over 90%, so some scholars advocate waiting for observation. The longer the remission period, the higher the probability of permanent skin lesion residue, so early treatment is often necessary, and can also reduce the psychological burden of the child’s family. Classification: Superficial hemangiomas (lesions located in the papillary layer of the dermis with a strawberry-like appearance), deep hemangiomas (lesions located in the reticular dermis or subcutaneous tissue with a pale blue elevation), and mixed hemangiomas (with features of both superficial and deep hemangiomas) are classified according to Suen and Waner criteria. Treatment: Traditional treatments include oral glucocorticoids, freezing, pinyamycin or anhydrous ethanol (pegylated alcohol) sclerotherapy injections, homoeopathic dosing, vincristine, cyclophosphamide, interferon alpha, freezing, surgery, injections and other sclerotherapy agents, but most of these methods and drugs have varying degrees of adverse effects and variable results. Since Léauté-Labrèze et al. first reported in 2008 that propranolol (a β-blocker, mainly used to treat cardiovascular diseases) has good efficacy in the treatment of infantile hemangiomas, studies related to the application of β-blockers in the treatment of infantile hemangiomas have continued to increase. timolol and propranolol are both non-selective β-blockers, and Guo and Ni in In 2010, Guo and Ni first reported the successful treatment of a 4-month-old superficial infantile hemangioma of the eyelid with timolol, which brings a new way of clinical treatment for infantile hemangioma. Currently, our department is using timolol maleate eye drops, oral propranolol, injections, laser and surgical resection to treat different types of infantile hemangiomas with good results (with typical cases).