Childhood angioma, what is it and what is its treatment?

A childhood angioma, also called a hemangioma, is the most common vascular lesion at an early age . Angiomas are benign tumors of the vascular system. Despite the label benign, the word ” tumor ” is sure to scare parents who receive the diagnosis. They are classified as tumors because there is a cellular proliferation of the endothelial cells of the blood vessels, whether they are veins, capillaries or arteries. That is, these cells of the vascular system multiply abnormally quickly and the result is characteristic red spots on the skin.They can appear anywhere on the body, although they are more frequent on the face and neck, followed by the trunk and extremities. These spots evolve to become quite striking red bumps.

Beyond the obvious aesthetic consequence, since it can become very disfiguring, childhood angioma can cause other types of problems depending on its size and location. It is possible that they affect vision if they are around the eye, swallowing if they are in the mouth, or that due to their ulceration they can cause intense pain, especially if they occur in the mucous membranes or in areas of the body in the that the skin tends to suffer frequent rubbing. Despite their tumorous condition, they do not spread to other organs or lead to malignant tumors. Only in a small part, around 1% of cases, can they be life-threatening, as a consequence of secondary complications depending on their location.

The causes of childhood angioma are unknown, although some studies find data that justify a genetic transmission. It is known that they are more frequent in premature babies or in children with low birth weight and that they are three times more frequent in girls than in boys . In general, its incidence is estimated to be around 10% in children under one year of age.

The first signs of its appearance usually occur a few days after birth. At first they appear as red spots on the skin and quickly evolve, becoming more intense and swelling . This characteristic clinic facilitates the diagnosis and analysis or imaging tests are not usually necessary, unless a differential diagnosis is needed. This would be, for example, to rule out a vascular malformation, which would manifest itself at birth and, in this case, would have growth in line with the child’s own growth and which would not disappear over time, as is the case with angiomas or hemangiomas.

PHASES OF CHILDHOOD ANGIOMA: PROLIFERATIVE AND INVOLUTIONAL

During the proliferative phase, the angioma increases in size and volume. Approximately up to nine months this rapid evolution occurs and is the time when complications can appear. After this stage, the angioma stabilizes.

In the involutional phase, infantile angioma gradually and spontaneously disappears. It is a very slow process, which can last up to ten years. Some studies establish that in 30% of cases they will disappear after three years , in 50% at five, in 70% at seven and in 90% at nine years. An angioma can disappear completely spontaneously, but it can also be the case that the disappearance of the skin spot is incomplete.

In general, we can distinguish between superficial and deep angiomas based on their place of appearance. The superficial ones are the most common . In the second case, they manifest as bumps under the skin, which can make diagnosis difficult.

Before the appearance of any of its signs, it is important to consult quickly with the pediatrician. In addition, the dermatologist will be the reference specialist to treat angiomas , establish the diagnosis, rule out possible secondary complications and mark the treatment to be followed.

TREATMENT OF CHILDHOOD ANGIOMA

Because the natural tendency of childhood angioma is involution , that is, it tends to disappear on its own, if there is no risk of damage to other body structures or there are excessively disfiguring injuries, professionals tend to take a passive, expectant and vigilant. In the event that it is decided to establish a treatment, the classic choice is glucocorticoids. They are given in high doses for several weeks and some of the side effects that can occur are gastrointestinal or sleep disturbances.

In 2008, a positive effect of propanolol, a drug initially indicated to treat hypertension , was discovered by chance . In recent years there have been numerous studies dedicated to proving its effectiveness and it is currently also a reference treatment.

There are other interventions such as laser surgery, but in any case It should be the specialist who establishes the most appropriate treatment, without forgetting to take care of the possible psychological consequences that children with childhood angioma may suffer when developing their body image, especially with the arrival of schooling.