What is an infantile hemangioma? How does it develop?

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Infantile hemangiomas are common vascular tumors. It is the most common benign tumor of young children, affecting between 4% and 10% of newborns. They are more frequent in little girls.
Infantile hemangiomas are linked to the proliferation of endothelial cells. This proliferation begins after birth, often around the first few days of life.
At birth, the skin is usually normal, sometimes pinkish or even red or anaemic (lighter in color).
This lesion goes through three phases:
- Proliferation phase
- Stability phase
- Involution phase
Regression of the haemangioma is complete in 50% of patients by the age of 5, and in 70% of cases, by the age of 7. By the age of 10-12 years, tumor involution is almost complete. At the end of the evolution, residual fatty tissue or a reddish discoloration of the skin may persist.

What causes hemangiomas?

The cause of this benign tumor is unknown.
Parents are in no way responsible. No food, medication or activity ingested during pregnancy is responsible for the appearance of a hemangioma.

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How is a hemangioma diagnosed? Where are they located?
Approximately 60% of hemangiomas are located in the head and neck region. Around 25% are found on the trunk, and 15% on the arms or legs.
Hemangiomas can be single (80% of cases), or multiple (20%). They may be on the surface of the skin or just under the skin.

In most cases (90% of cases), the diagnosis of infantile hemangioma can be made on the basis of the child's history, clinical examination and early life photos.
Further examination (ultrasound or MRI) is sometimes required for diagnosis, or to explore the depth of the tumor.
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When should a specialist be consulted for children's hemangiomas?
As the most common benign tumor, in the majority of cases hemangiomas require no follow-up.
However, it is necessary to consult a specialist if the hemangioma:
- is located on or around certain parts of the body: the eye, nose, mouth, ear, buttocks, chest
face and neck
- progresses very rapidly
- causes skin ulcerations, minimal bleeding or skin superinfections
- is of multiple location
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How are hemangiomas treated?
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Most hemangiomas do not require medical treatment or follow-up. Unsightly sequelae may sometimes require correction by surgery or pulsed dye laser.
However, if there is a risk of permanent unsightly sequelae, particularly in the periorificial regions of the face, hyperalgesic ulceration or functional repercussions, medical treatment with Propranolol may be introduced in the first months of life.

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