Hemangiomas of infancy are the most common benign tumors of childhood. They are composed of proliferating endothelial tumor cells and usually manifest as cutaneous birthmarks. In most cases, these tumors characteristically follow a natural course of regression. However, they can cause a tremendous amount of anxiety. Hemangiomas can threaten vital life processes if located in certain areas of the body. They may also be part of larger syndromes associated with high rates of life-changing morbidity and mortality. In all of these situations, hemangiomas are often referred due to the uncertainties that exist regarding the most efficacious diagnosis and management.

Hemangiomas of infancy.J Am Acad Dermatol. 2003 Apr;48(4):477-93; quiz 494-6.

Hemangiomas of infancy are unique, benign, pediatric tumors of endothelial cells characterized by an initial phase of rapid proliferation, followed by slow involution, often leading to complete regression. Although most of these tumors are small and innocuous, some may be may be life- or function-threatening, or have associated structural congenital anomalies. Uncertainties regarding their diagnosis or management often prompt referral to a dermatologist. The pathogenesis of hemangiomas of infancy is not well understood, but recent findings suggest a unique vascular phenotype with dysregulated vascular homeostasis. This article reviews new information regarding the pathogenesis of these tumors and highlights the more worrisome presentations, including syndromic hemangiomas, that are likely to be problematic. In addition, management strategies and treatment options are discussed. (J Am Acad Dermatol 2003;48:477-93.) Learning objective: At the completion of this learning activity, participants should be able to describe the clinical features of hemangiomas of infancy and potential complications as well as to understand the strengths and limitations of various treatment options.

Hemangiomas of infancy: clinical and biological characteristics.Clin Pediatr (Phila). 2005 Nov-Dec;44(9):747-66.

Hemangiomas of infancy are common in the general pediatric population, are usually easily diagnosed, and generally do not require treatment. However, a small but significant percentage of hemangiomas of infancy may develop complications, including infection or ulceration. In addition, hemangiomas located in some anatomic regions may be associated with other anomalies and therefore require more careful monitoring and earlier intervention to prevent permanent sequelae. This review focuses on distinguishing hemangiomas from vascular malformations and delineates the natural history of hemangiomas of infancy, with an emphasis on identifying those hemangiomas that require additional evaluation and closer follow-up. Current treatment modalities, including the use of systemic steroids and the pulsed-dye laser, are discussed. In addition, several conditions that often present with cutaneous hemangiomas are described, including PHACES syndrome and neonatal hemangiomatosis. Finally, an assessment is made of the current understanding of the biology of hemangioma proliferation and involution, including the role of endothelial growth factors and GLUT1, a new marker for hemangiomas of infancy.