Ontogeny of Infantile Hemangiomas With Skin Imaging Modalities

Infantile hemangiomas (IH) are relatively common benign vascular neoplasms, which appear shortly after birth and grow rapidly in the following weeks and months. The proliferative phase involves a rapidly dividing endothelial cell proliferation. The tumors generally stabilize and then involute over time. They are usually clinically insignificant; however, a small percentage of them can be life threatening secondary to location, associated syndrome, and physical findings such as ulceration. Treatment options have included steroids, interferon, vincristine and more recently propranolol. There are few published prospective research studies on the effectiveness of these treatment options. Because of several factors, it has been difficult to objectively measure response of these lesions. The purpose is to determine (1) whether multiple quantitative skin imaging modalities can quantitatively describe the clinically relevant features of infantile hemangiomas, including color (red, blue), lightness, size (height, volume), biomechanical properties, temperature and perfusion and (2) the natural ontogeny and response to treatment over time. The treatments are oral propranolol, topical timolol and untreated (observation).

Inclusion criteria

• Age ≤ 5 years of age
• Diagnosis of a cutaneous infantile hemangioma
• Diagnosis of hemangioma requiring treatment (treatment includes: propranolol or topical timolol) or diagnosis of an infantile hemangioma that will not be treated at the time of enrollment
• Able to tolerate imaging procedures

Exclusion criteria

• Age > 5 years
• Non cutaneous infantile hemangioma
• Hemangioma on the lip
• Hemangioma on the eyelid
• Hemangioma located in areas whereby measurements cannot be made due to equipment limitations
• Deep hemangioma with no visible skin surface component
• Congenital hemangioma
• No available normal site for study control
• Other vascular anomaly
• Not able to tolerate imaging procedures