Follow-up and management of childhood hemangiomas

Vascular lesions, especially hemangiomas, are common in infants and children. They have a proliferative phase in early infancy followed by an involutional phase, leading to complete, spontaneous regression in most patients. Involution usually begins by 1 year and continues over 4 to 6 years. Only a minor cutaneous blemish will remain. Fortunately, most hemangiomas only grow to a small size and do not cause problems. However, there is a small subset of hemangiomas that destroy tissue or endanger the infant's life, either because of the tumor's size, location or aggressive growth. Pediatricians must be prepared to respond to the anxious parents' questions. Pediatricians continue to play a pivotal role in the management of infantile hemangiomas. They are usually the first to discover the tumor or the cutaneous marks. They must see the infant frequently because it is difficult to predict the ultimate size and behavior of a particular tumor.