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Retrospective Study of Nasal Infantile Hemangiomas: Characteristics, Complications, and Outcomes
Author(s) -
Kryatova Maria S.,
Rainer Barbara M.,
Zhao Jiawei,
Villarroel Vadim A.,
Yasmine Kirkorian Anna,
Grossberg Anna L.,
Puttgen Katherine B.,
Cohen Bernard A.
Publication year - 2016
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12995
Subject(s) - medicine , retrospective cohort study , telephone interview , psychosocial , surgery , pediatrics , social science , sociology , psychiatry
Background/Objectives Nasal infantile hemangiomas ( IH s) pose serious medical complications and psychosocial stress if tumor involution is incomplete or prolonged. The objective was to determine which IH characteristics are associated with complications and are predictive of outcome, assessed as the presence of IH s or residual skin changes upon kindergarten entry, to better manage these lesions and counsel families. Methods A retrospective chart review of all patients seen in the Division of Pediatric Dermatology at Johns Hopkins Medicine between 2001 and 2014 for nasal IH s ( N = 89) was performed. A follow‐up telephone interview with parents was conducted in June and July 2014. Results Complications were observed in 39% of patients. Segmental and indeterminate IH s were more likely to have complications than focal IH s (p = 0.01). Mixed IH s were more likely to ulcerate than deep or superficial IH s (p = 0.01). Eighty percent of patients had treatment and 19% had surgery. Although IH s regressed by kindergarten entry in 70% of patients, 78% of these patients had residual skin changes. Mixed and superficial IH s left more residua than deep IH s (p = 0.04). A statistical comparison of treatments with respect to outcome at kindergarten entry could not be made because subgroups were too small and heterogeneous. Conclusion Nasal IH s had higher rates of complications and treatment than previous reports of IH s at all body sites. Lesions of segmental and indeterminate type and mixed depth should be identified as high risk and treated accordingly. Parents may be counseled that most nasal IH s involute by kindergarten but leave residua and that early referral for treatment may be important for the best outcome.