Management of infantile hemangiomas

Abstract

Infantile hemangiomas (IH) are one of the most common vascular tumors in children. They are benign vascular endothelial neoplasms that follow a predictable clinical course usually appearing during the first three weeks of life, then entering a proliferative phase, characterized by rapid growth between three and nine months, followed by slow spontaneous regression and tumor involution. They are heterogeneous tumors that vary in size, depth, location and growth pattern. A multimodal and multidisciplinary approach is therefore often necessary. Most IH resolves spontaneously, but a subset of affected patients are at risk for complications in 10 to 20% of cases. The prognosis of IH can be linked to aesthetic, functional but also and above all vital damage. Therapeutic management varies from therapeutic abstention to surgical treatment. Propranolol, a non-cardio-selective beta-blocker, represents the mainstay of systemic treatment of hemangiomas in patients older than five weeks. In this article, we carried out a review of several scientific articles in order to take stock of the different therapeutic approaches and propose a decision-making algorithm for the management of IH.