Ulceration in Congenital Hemangiomas

Abstract

Objectives: The objective of this study is to describe the clinical features, treatment course, and complications of patients with congenital hemangiomas (CH) with ulceration. Methods: Multicenter retrospective study of patients with CH who developed ulceration as a complication. Results: Data for 20 subjects with ulcerated CH was analyzed. CH were more commonly located on the extremities (60%), followed by the head and neck (35%) and trunk (5%). Three clinical morphological variants were recognized, most patients presented with an exophytic vascular tumor (70%). Among patients with available information to determine the postnatal course, 62.5% represented partially involuting CH, while 37.5% were rapidly involuting CH. Secondary complications occurred in 35% of patients including thrombocytopenia, coagulopathy, bleeding, sepsis, including one fatal case. Conclusion: Ulceration is an important complication of involuting CH. Bleeding, coagulopathy, sepsis, and death are potential secondary complications. Care for these patients requires a multidisciplinary approach, ensuring close follow up and education for parents and caregivers.