A retrospective multicenter cohort study of differences in clinical characteristics of Infantile Hemangiomas in preterm and term infants: Prematurity increases risk of permanent cutaneous sequelae - 29/11/24

Doi : 10.1016/j.jaad.2024.09.066

Flora E. Bradley, MD ^a,^⁎ , Esteban Fernández Faith, MD ^b, Sonal D. Shah, MD ^a,^c, Mitchell Braun, MD ^a, Elena Pope, MD ^d, Irene Lara-Corrales, MD ^d, Patricia M. Witman, MD ^b, Katya Harfmann, MD ^b, Amy Buros Stein, PhD ^e, Ilona J. Frieden, MD ^a
^a Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California
^b Division of Dermatology, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio
^c Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
^d Division of Pediatric Dermatology, The Hospital for Sick Children and University of Toronto, Toronto, Canada
^e Pediatric Dermatology Research Alliance, Portland, Oregon

^∗Correspondence to: Flora E. Bradley, MD, Department of Dermatology, Division of Pediatric Dermatology, 1701 Divisadero Street, 3rd Floor, San Francisco, California 94115.Pediatric DermatologyUniversity of California1701 Divisadero StreetThird FloorSan FranciscoCalifornia94115

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Friday 29 November 2024

Abstract

Background

We observed many preterm infants with unexpectedly thick infantile hemangiomas (IH), a subtype known to be associated with an increased risk of scarring.

Objective

To cf the clinical features of localized IH in preterm vs term infants.

Methods

A retrospective study was conducted at 3 tertiary referral centers involving 830 consecutive patients with localized IH.

Results

Preterm infants had a significantly higher incidence of superficial IH (75% in <33 weeks, 57% in 33 to <37 weeks, and 50% in term infants, P = .007). Overall, their IH had thicker superficial components (P < .001) and more stepped borders (P < .001). These features correlated with the degree of prematurity. The average chronological age at presentation to the specialist was 5.6 (SD = 6.2) months, with no difference observed in gestational age.

Limitations

The retrospective design and use of nonstandardized clinical photographs. There may be biases introduced toward more severe IH types because the study sites were tertiary referral centers.

Conclusions

Preterm infants have features of IH that have obvious implications for systemic therapies. Most of these infants were seen beyond the typical proliferative phase when irreversible skin changes may have already occurred.

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Key words : clinical research, infantile hemangioma, pediatric dermatology

Esquema

Infantile hemangioma clinical characteristics

Age at presentation to the subspecialist

Treatment

Discussion

Conclusions

	Funding sources: This study was supported by the Pediatric Dermatology Research Alliance (PeDRA).
	IRB approval status: Approved at all three Institutions.
	Article Summary: This study shows a correlation between the degree of prematurity and certain morphologic characteristics of infantile hemangiomas, which are associated with permanent sequelae.