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Vascular Birthmarks

Haemangiomas

The word haemangioma comes from the Latin words 'haem' meaning blood and 'angioma' meaning growth of cells. A haemangioma is a collection of small blood vessels that produces a lump in the skin. Haemangiomas can be superficial (capillary) or deep (cavernous). They are sometimes called strawberry marks. Approximately 1 in 10 babies have haemangioma, and they tend to be more common in girls, twins, triplets and premature babies or in mothers who presented with bleeding in pregnancy. They are usually not present at birth but develop a few days to weeks later. Initially there may be a small area of pale skin followed by a red spot. They grow rapidly in the first three months increasing in size and may intensify in colour. It is unusual for a haemangioma to grow after ten months. After this the haemangioma tends to have a rest period and will gradually improve with time. By the age of three years there are obvious signs of' reduction in size and most small haemangiomas will disappear leaving little or no mark on the skin by the age of five years. Large haemangiomas may continue to reduce in size up to seven to nine years of age.

Deep (cavernous) haemangiomas may appear bluish in colour because the abnormal blood vessels are deeper in the skin. Some haemangiomas may distort or stretch the skin around the lesion when it has completely disappeared. Sometimes there may be 'left over' fatty tissue following the regression of the haemangioma. In these situations, plastic surgery may be necessary.

Haemangiomas can appear anywhere on the body; rarely they can also he present in the internal organs. If this is the case, ultra sound scanning, magnetic resonance imaging (MRI), or rarely CT scan, may be indicated. Sometimes there can be more then one haemangioma in the same patient.

Most haemangiomas do not require any treatment, but some may need to be treated soon after birth if they interfere with feeding, breathing or other body functions. If the haemangioma presents on the child's eyelid, it may need urgent treatment in the first few weeks of life, as it may interfere with the development of the child's vision.

Some children with haemangiomas may require treatments with a pulsed dye laser, steroids or surgery. Those that have ulcerated or become sore may need to be admitted to hospital for treatment with antibiotics, dressings and regular nursing care.

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Medical text written August 2001 by Dr S B Syed. Last updated January 2006 by Dr S B Syed, Associate Specialist in Paediatric Dermatology, Great Ormond Street Hospital, London, UK.

 

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