SURGICAL-MANAGEMENT OF EVOLVING CAPILLARY HEMANGIOMAS IN CHILDHOOD

On the basis of a large series of cases, the authors define and illustrate the characteristics of evolving capillary hemangiomas (ie, congenital vascular capillary lesions that do not undergo spontaneous regression after the first eight to ten months of life), focusing on how they evolve and the ensuing need for early treatment. The progressive growth and expansion in the cutaneous-subcutaneous (and at times muscular) district is due to the dilation and confluence of capillaries and progressive formation of confluent cavities resulting from the breaking of the interlacunar septa and from endothelial proliferation. The authors point out the sites most frequently involved: lips, eyelids, and cheeks, with considerable repercussions on the cosmetic-functional unit. The clinical aspects are also discussed, especially in relation to the location and development of a single lesion, as well as the diagnostic and therapeutic aspects of the disorder. Special attention is paid to surgical treatment, which must obviously be conservative and must be designed as a multistep procedure so as to avoid useless mutilation and make sure that the scar tissue due to the surgical sclerosis will contribute to the reduction of the angiomatous lesion.