Kathleen F O'Brien1, Sonal D Shah2, Elena Pope3, Roderic J Phillips4, Francine Blei5, Eulalia Baselga6, Maria C Garzon7, Catherine McCuaig8, Anita N Haggstrom9, Peter H Hoeger10, James R Treat11, Marissa J Perman11, Jane S Bellet12, Xavier Cubiró6, Jeffrey Poole13, Ilona J Frieden14. 1. Georgetown University School of Medicine, Washington DC. 2. University of California, San Francisco, California. Electronic address: sonal.shah@ucsf.edu. 3. The Hospital for Sick Children, Toronto, Canada; University of Toronto, Toronto, Canada. 4. Royal Children's Hospital, Melbourne, Australia. 5. Lenox Hill Hospital, Northwell Health, New York, New York. 6. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 7. Department of Dermatology, Columbia University, New York, New York; Department of Pediatrics, Columbia University, New York, New York. 8. Sainte-Justine University Hospital Center, Montreal, Canada. 9. Department of Dermatology, Indiana University, Indianapolis, Indiana; Department of Pediatrics, Indiana University, Indianapolis, Indiana. 10. Department of Pediatric Dermatology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany. 11. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 12. Department of Dermatology and Pediatrics, Duke University, Durham, North Carolina. 13. Children's Hospital New Orleans, New Orleans, Louisiana. 14. University of California, San Francisco, California.
Abstract
BACKGROUND: The proliferative phase of infantile hemangiomas (IHs) is usually complete by 9 months of life. Late growth beyond age 3 years is rarely reported. OBJECTIVE: To describe the demographic and clinic characteristics of a cohort of patients with late growth of IH, defined as growth in a patient >3 years of age. METHODS: A multicenter, retrospective cohort study. RESULTS: In total, 59 patients, 85% of which were female, met the inclusion criteria. The mean first episode of late growth was 4.3 (range 3-8.5) years. Head and neck location (55/59; 93%) and presence of deep hemangioma (52/59; 88%) were common characteristics. Posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects, eye abnormalities (PHACE) syndrome was noted in 20 of 38 (53%) children with segmental facial IH. Systemic therapy (corticosteroid or β-blocker) was given during infancy in 58 of 59 (98%) and 24 of 59 (41%) received systemic therapy (β-blockers) for late IH growth. LIMITATIONS: The retrospective nature and ascertainment by investigator recall are limitations of the study. CONCLUSION: Late IH growth can occur in children after 3 years of age. Risk factors include head and neck location, segmental morphology, and involvement of deep dermal/subcutaneous tissues. Crown
BACKGROUND: The proliferative phase of infantile hemangiomas (IHs) is usually complete by 9 months of life. Late growth beyond age 3 years is rarely reported. OBJECTIVE: To describe the demographic and clinic characteristics of a cohort of patients with late growth of IH, defined as growth in a patient >3 years of age. METHODS: A multicenter, retrospective cohort study. RESULTS: In total, 59 patients, 85% of which were female, met the inclusion criteria. The mean first episode of late growth was 4.3 (range 3-8.5) years. Head and neck location (55/59; 93%) and presence of deep hemangioma (52/59; 88%) were common characteristics. Posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects, eye abnormalities (PHACE) syndrome was noted in 20 of 38 (53%) children with segmental facial IH. Systemic therapy (corticosteroid or β-blocker) was given during infancy in 58 of 59 (98%) and 24 of 59 (41%) received systemic therapy (β-blockers) for late IH growth. LIMITATIONS: The retrospective nature and ascertainment by investigator recall are limitations of the study. CONCLUSION: Late IH growth can occur in children after 3 years of age. Risk factors include head and neck location, segmental morphology, and involvement of deep dermal/subcutaneous tissues. Crown