Premonitory markers at birth in 50: red telangiectatic, bluish “bruise-like” or white “anemic” macules Superficial hemangioma: bright red, “strawberry”-like papules and plaques (during proliferative phase) Deep hemangioma: warm, rubbery mass under normal-

Progression

0 0.5 ~5 (varies)

Age (years)

Vascular malformations

Proliferating hemangioma

Involuting hemangioma

Involuted hemangioma

InfanIl hemangioma Mixed Hemangioma

•  Most common hemangioma •   Female is more than male, raIo 2:1 •  More in premature infant and mulIple

gestaIon pregnancy •  Not full developed when birth, but start to

grow soon aQer, the proliferaIve phase follow by slower involuIon phase

Pathophysiology

•  Hemangioma cells are immature and imcomplete differenIated

•   Rapid growth for the first few months follow by self destrucIon by apoptosis





11 months peak of proliferaIng phase

2 years old involuIng phase, apoptosis almost max

4 years old, some further

involuIon

Most of IH completed their course at 7-­‐10 years

Skin aQer involuIon

•  Superficial IH: normal skin •   Atropic, Some scar, fibroadipose degeneraIon •   Residual teleangiectasia

Types of IH

•  Superficial dermis: bright in color •   Deep dermis and subcutaneous: normal skin

color to blue colors •   CombinaIon: superficial, deep and

subcutaneous

 

   

                                          

          

    

Mandibular segmental IH( beard distribuIon) with laryngeal

hemangioma (airway hemangioma)

 ComplicaIon      

•  UlceraIon   

•    Block the vision

•  Block the airway                                 

Medical IntervenIon  Surgical intervenIon

•  CorIcosteroid

•   Propanolol

•  Pulsed dye laser for superficial IH

  Other vascular tumor  

NICH

•  Congenital or non progressive hemangioma 

       •   Rapidly involuIon and non involuIon    

Angioblastoma of Nakagawa

RARE

Vascular malformaIon, PWS baby, Pyogenic granuloma surface halus, lesi akan persistent

Jaringan dibawah tumor juga bisa PWS pada dewasa

overgrowth

Infant of portwine stain at risk of

PWS of the body

Sturge Weber Syndrome

V1, V2 and V3

Sturge-­‐Weber Syndrome Risk of Sturge-­‐Weber Syndrome

•  Sturge-­‐Weber syndrome (SWS), also called encephalotrigeminal angiomatosis, is a neurocutaneous disorder with angiomas that involve the leptomeninges (leptomeningeal angiomas [LAs]) and the skin of the face,

typically in the ophthalmic (V1) and maxillary (V2) distribuIons of the trigeminal nerve

LymphaIc malformaIon

Dorman AVM

Dorman AVM

Expanding type

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Selamat belajar

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