Vascular Birthmarks Infantile and congenital haemangiomas

Haemangiomas

Haemangiomas are common birthmarks caused by overgrowths of blood vessels in the skin. About one third of them are found at birth, the rest of them appear in the first month of life. The underlying caues of haemangiomas is not known. The majority of them grow raipdly in the first year of life, before gradually disappearing.

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Dr Clayton along with researchers from several European countries has developed a protocol for treating haemangiomas with a beta blocker (propranolol). Indeed Tim has successfully treated over 100 children with propranolol.

Approximately 80% occur on the head and neck. Hemangiomas that are flat and appear reddish in colour are called “superficial” and those that are deeper in the skin and appear bluish in colour are called “deep” hemangiomas. Hemangiomas can grow for up to 18 months and then begin to reduce in size slowly. This is known as involution. This involution can last from 3- 10 years. While all hemangiomas eventually ‘involute” the result is not always cosmetically acceptable.

HOW COMMON ARE THEY?

Haemangiomas occur in roughly 3% of all newborn babies and are seen more commonly in premature small babies. They affect both boys and girls, but tend to occur more often in girls.

WHERE DO THEY OCCUR?

Most haemangiomas occur on the head and neck. They can occur anywhere on the skin or inernal organs.

WHAT DO THEY LOOK LIKE?

They range in colour from pink to blue and may appear flat or lumpy. Flat haemangiomas are called “superficial” and are due to blood vessels in the upper layer of the skin, the epidermis. The lumpy ones are often deeper involving the deep part of the skin, the dermis. they may affect both layers of the skin.

HOW CAN THEY BE TREATED?

Most disappear slowly without the need for any treatment. However in the last 2 years a series of exciting developments have found that propranolol, a betablocker used to lower blood pressure, can have dramatic effects on the rapid growth of haemangiomas and cause them to shrink. Dr Clayton has treated over 60 children with this medication with enormous success.

Dr Clayton uses this medication for haemangiomas that are in dangerous locations such as near the eye, nose, mouth, nappy area or if the haemangioma has become ulcerated and painful.

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Laser may be used to help haemangiomas that are bleeding or ulcerated but are not usually needed.

Dr Clayton has treated over 100 children with oral propranolol and has even started using topical propranolol therapy now.

He has recruited 50 children into a large European Study (PITCH study) that is looking into the treatment of haemangiomas with propranolol.

 

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