Infantile hemangiomas: New segmental mapping finds new patterns

A newly recognized C-shaped pattern of segmental scalp hemangioma is among the findings of a study that analyzed 549 segmental and indeterminate infantile hemangiomas (IHs). The hemangiomas were mapped using a standardized template.


The retrospective cohort study, published in JAMA Dermatology (doi:10.1001/jamadermatol.2021.3479), used patient photographs to assess both segmental and indeterminate hemangiomas in children. The researchers report that while the borders of the frontotemporal (S1) and frontonasal (S4) segments agreed with previous segmental maps, the maxillary (S2) and mandibular (S3) segment borders were different.


They wrote: “In contrast with previous reports, preauricular skin segregated with the mandibular (S3) rather than the maxillary (S2) segment. Indeterminate hemangiomas occurred within and respected the same borders as segmental hemangiomas. Hemangiomas on the lateral scalp commonly occurred in a C shape extending from the posterior auricular region.”


The authors say their study provides evidence that indeterminate hemangiomas are partial segmental hemangiomas that respect the anatomic boundaries of larger segmental IHs.


“Recognizing segmental infantile hemangioma (IH) patterns is important for risk stratification and provides clues to pathogenesis,” Dr. Alyson A. Endicott, of the department of dermatology at the UCSF School of Medicine at University of California, San Francisco, and colleagues wrote.


The study was conducted at four pediatric dermatology centres: University of California, San Francisco; Indiana University; Medical College of Wisconsin; and Northwestern University/Ann & Robert H. Lurie Children’s Hospital of Chicago.

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