Capillary Hemangioma Treatment & Management

Capillary Hemangioma Treatment & Management

Write a short note on capillary hemangioma.

Answer. Capillary hemangioma is of three types i.e.

• Salmon patch
• Strawberry hemangioma
• Port-wine stain.

Capillary Hemangioma Salmon Patch

• It is present at the time of birth.
• It commonly occurs at the nape of the neck, face, scalp, and limbs.
• The lesion involves a wide area of skin.
• It is caused due to the area of persistent fetal dermal circulation.
• It regresses with age and disappears completely.

Capillary Hemangioma Strawberry Hemangioma

• The child is normal at birth, but between 1 to 3 weeks lesions appear as red marks which increase in size to 3 months.
• This is a true capillary hemangioma.
• The lesion is 20 times more common than port-wine stain.
• The lesion is seen more commonly in white girls
• Its male-to-female ratio is 1:3.
• The lesion occurs most commonly in the head and neck region.
• On palpation, the lesion is compressible and warm with a bluish surface.
• The lesion involves skin, muscles, and subcutaneous tissues.
• The lesion begins to disappear one year of age and it completely regresses in 7 to 8 years.

Capillary Hemangioma Port-wine Stain

• It occurs at birth and persists throughout the life.
• It presents as smooth, flat, reddish blue or purplish.
• The lesion is common in the head, neck, and face.
• Eventually surface of the lesion becomes nodular and keratotic.
• It results from a defect in the maturation of sympathetic innervations of skin causing localized vasodilatation of intradermal capillaries.
• It requires cosmetic coverage. Excision, grafting, or LASER ablation.

Capillary Hemangioma Treatment Of Capillary Hemangioma

• They are treated by wait and watch policy commonly allows for spontaneous regression.
• Diode laser, surgical excision, and reconstruction may need to be ligated after wide exposure before achieving complete extirpation.
  Sclerotherapy/Cryotherapy/CO2 snow therapy causes unpleasant scarring.
• Preoperative embolization facilitates surgical excision and reduces operative blood loss. When once embolization
  done surgery should be done as early as possible otherwise recurrence occurs and much more worry formation of enlarged collaterals can occur.
• Rapidly growing hemangioma may need systemic/oral and intralesional steroid therapy.
  Antiangiogenic interferon 2a may be useful.
• Life-threatening platelet trapping may be controlled by cyclophosphamide chemotherapy.
• Hemangioma with drug-resistant CCF can be treated with radiotherapy.