Multifocal Infantile Hemangioma - Presentation of 4 Cases and Review of the Selected Literature.

Aleksandra Matić, Milan Matić, Sonja Prćić, Anica Radulović, Miloš Pajić, Milica Žeravica
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Abstract

Background: Multifocal infantile hemangiomas (IHs) are focal cutaneous lesions affecting more than 1 anatomic site. The multifocal distribution pattern is the rarest form of IH manifestation, accounting for only 3-4% of all affected infants. This type of cutaneous IHs may be a marker for extracutaneous disease, with the liver being the most frequently affected organ.

Methods: We investigated the clinical and epidemiological characteristics of a small case series of infants with multifocal IHs presenting with different clinical patterns, all diagnosed and treated in a regional tertiary-care pediatric clinic.

Results: Four infants with multifocal IHs were included in the analysis. There were 3 girls and 1 boy. Three out of 4 infants were prematurely born (2 of them very preterm), while only 1 was full-term. Clinical patterns in all cases were quite different, but more than 20 cutaneous IHs were present in each of the patients. Two infants had multifocal liver hemangioma, but without complications. In 3 out of 4 patients, systemic propranolol therapy was introduced, with excellent response in two cases (both with liver involvement).

Conclusion: With the increase in the number of cutaneous IHs, the probability of internal organ involvement, most often the liver, also increases. Evaluation for extracutaneous lesions is indicated in infants with 5 or more cutaneous IHs. Treatment of infants with multifocal IHs should be individualized and consider all relevant risk factors, including prematurity.

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多灶性婴儿血管瘤--4 例病例介绍及文献综述。
背景:多灶性婴儿血管瘤(IHs)是影响一个以上解剖部位的局灶性皮肤病变。多灶分布模式是最罕见的 IH 表现形式,仅占所有患病婴儿的 3-4%。这种类型的皮肤 IH 可能是皮肤外疾病的标志,肝脏是最常受影响的器官:我们调查了一个小型病例系列的临床和流行病学特征,这些婴儿患有多灶性 IHs,表现出不同的临床模式,均在一家地区三级儿科诊所接受诊断和治疗:结果:4名患有多灶性IH的婴儿被纳入分析范围。其中有 3 名女孩和 1 名男孩。4 名婴儿中有 3 名是早产儿(其中 2 名是极早产儿),只有 1 名是足月儿。所有病例的临床模式大相径庭,但每个患者都有超过 20 个皮肤 IHs。两名婴儿患有多灶性肝血管瘤,但没有并发症。4 例患者中有 3 例接受了全身普萘洛尔治疗,其中 2 例反应良好(均累及肝脏):结论:随着皮肤血管瘤数量的增加,内脏器官(最常见的是肝脏)受累的可能性也在增加。对于有 5 个或 5 个以上皮肤 IH 的婴儿,应进行皮肤外病变评估。多灶性 IH 婴儿的治疗应个体化,并考虑所有相关的风险因素,包括早产。
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