What are the clinical manifestations of infants with hemangiomas?

Hemangiomas are tumors on the blood vessels of the skin, most commonly in infants and children. Hemangiomas often grow on the face, neck, liver, etc. and have obvious port-wine stains. Not only will it affect the baby's appearance, but the rapid expansion from 2 to 8 months makes many parents worried. Sometimes the hemangioma disappears as the baby grows without treatment, but sometimes it affects the baby's health.

Clinical manifestations

1. Port-wine stain: also known as telangiectatic nevus or port-wine stain, it manifests as one or several dark red or bluish-red patches with irregular edges, not protruding above the skin surface, and easily faded when pressed. It is more common on the head and neck, often appearing at birth, and may increase in size as the body grows. Those occurring on the occipital region, forehead, or bridge of the nose may resolve on their own, while larger or extensive lesions often persist for life.

2. Capillary hemangioma: also known as strawberry nevus, it appears as one or several bright red, soft, lobed tumors that do not fade when pressed. It often occurs on the head and neck. It usually does not appear at birth, but appears within a few weeks after birth, enlarges within a few months, grows rapidly, and can even reach several centimeters. Most of them grow to their maximum size within 1 year of age and then regress on their own, disappearing completely or incompletely within a few years.

3. Cavernous hemangioma: The lesions are generally large and occur spontaneously. They occur at the site of the original capillary hemangioma or are located under the skin. They are round or irregular in shape, may be higher than the skin surface, and may be nodular or lobed. The boundaries are not clear, and the texture is soft and elastic. They are mostly light purple or purple-blue. They may shrink after squeezing. The surface skin may be normal or atrophied by adhesion to the tumor. It occurs at birth or shortly after birth, often on the scalp and face, and may involve the oral or pharyngeal mucosa.

Cavernous hemangioma may be accompanied by thrombocytopenia and purpura. It mainly occurs in infants and occasionally in adults. It is a serious type, and about 1/4 of cases die from bleeding, respiratory tract infection or malignancy.

Diagnostic criteria

1. Fixed-position erythematous lesions can be seen on the skin surface, which fade temporarily after light pressure.

2. A lump that protrudes from the skin tissue can be reduced by pressing. Diagnostic puncture of a tumor with a positive perfusion sign can obtain whole blood or bloody lymphatic tissue fluid.

3. Arterial infantile hemangioma may have clear arterial pulsation.

4. Characteristic images can be seen by B-ultrasound and color ultrasound examinations.

5. X-ray examination of the affected area reveals dilated and malformed blood vessels.

6. CT and MRI examinations are positive.