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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