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Infantile Hemangiomas are Often Present at Birth
Chelsey Johnson, Jessica Lee, Megan Natali, Amy Davis, Noel Jabbour, Sabri Yilmaz, James Park, Chido Vera, Andrew McCormick, Lorelei Grunwaldt
University of Pittsburgh Medical Center
2016-02-01
Presenter: Chelsey Johnson
Affidavit:
Lorelei Grunwaldt
Director Name: Lorelei Grunwaldt
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose: While widely accepted that Infantile Hemangiomas (IH) are not present at birth, this has not been consistent with our observations.
Methods: Retrospective chart review of patients with IH at a multidisciplinary vascular anomalies center from 2009-2015. Data included type of IH (superficial, mixed, or deep) and time when first noted.
Results: 473 of 500 patients identified with IH had complete data and were included. 51% of hemangiomas were superficial, 27% mixed, and 22% deep. Time at which the hemangioma was first noted was skewed right in superficial and mixed IH, with a median appearance at 3 days of life in superficial and 7 days in mixed IH, compared to 47 days in deep IH. There was a statistically significant difference between the deep IH compared to the superficial (p<0.0001) and mixed IH (p<0.0001). Timing of the appearance of IH is noted cumulatively as follows. On day of life 0 (DOL0), 46% of superficial, 42% of mixed, and 12% of deep IH had been noted. By DOL7, 69% of superficial, 52% of mixed, and 19% of deep IH had been noted. By DOL30, 93% of superficial, 84% of mixed, and 38% of deep IH had been noted. Combining all three types of IH, 37% were noted by DOL0, 53% by DOL7, and 79% by DOL30.
Conclusion: Greater than one third of all IH were noted at birth and over half were present by one week. This retrospective review challenges the accepted literature stating that IH are not present at birth.
