Hemangiomas of infants: Causes and ways of treatment

Hemangiomas are the most frequent benign tumors of infancy…
The frequency of their occurrence lie in the range of 4-5%. Appear more frequently in infants with a history of prematurity, the girls (2-3 times more often than boys) and in infants πολύδιμων pregnancies. It is also more frequently in the babies of mothers of advanced age, mothers with a history of προεκλαψίας (condition associated with increased pressure in pregnancy) and for placenta previa. Usually appear sporadically although cases have been reported that are inherited in an autosomal dominant character (i.e. if one of the two parents presents a hemangioma then the chance of the kid is 50%).
Due to the hemangiomas;
The hemangiomas arise from the disorderly, and without a specific course of creation of small vessels in some area of the body, mainly the skin.
At what age are displayed, and how that evolve?
The hemangiomas usually appear on the third to fifth week of life. At birth, most of the times don’t look or have the form of a mild τηλαγγειεκτασίας (redness of the skin). Then begin to grow for about 3 to 6 months, and rarely for 2 years. Following the stabilization in the size of the αιμαγγειώματος in formerly a period of time and, in the process subsides gradually. 50% of the children recedes at the age of 5 years and 70% at the age of 7 years. At this point, however, that it was the hemangioma is usually a small scar, a small speck.
Where identified hemangiomas;
Are commonly identified in the head and neck (60%) but can appear in any part of the body such as the trunk (25%) and extremities (15%). It can also appear in internal organs of the body like the liver. About 20% of infants show multiple hemangiomas.
What are the types of αιμαγγειωμάτων it?
Depending on the depth of extended hemangiomas on the skin are divided into superficial (hemangiomas of the “surface” of the skin), deep (hemangiomas in the depth of the skin) and mixed. The superficial hemangiomas occur more superficially in the skin.
What are the possible complications of αιμαγγειωμάτων it?
The hemangiomas can cause disorder in the vital functions of the organism (e.g., a hemangioma near the eyelid can affect vision). May also exhibit bleeding and infection. It should not be overlooked, however, and the psychological burden that can cause a hemangioma to the parents or to the child itself.
What is the treatment of αιμαγγειωμάτων it?
A. Drug therapy
Most of the times you do not require any treatment because of the benign nature and course of αιμαγγειωμάτων. In cases, however, caused complications and especially when they are prejudicial to the vital functions of the body require treatment. Drugs that until recently have been used for the treatment of αιμαγγειωμάτων is cortisone, vincristine and interferon. In the last years in the treatment of αιμαγγειωμάτων used propranolol. Propranolol is medicine used for diseases mostly of the heart. Causes vasoconstriction, interferes with the development of the αιμαγγειώματος and accelerates apoptosis (apoptosis is the programmed cell death).
B. Laser treatment
The laser treatment is done in specialized centers by doctors who have experience in this subject.
What tests are required to be made before the start of a child treated with propranolol that?
Before the start of treatment with propranolol it is necessary to make examination of the child by a pediatric cardiologist. Measuring blood pressure, electrocardiogram and ultrasound of the heart. In parallel, we have to measure the glucose in the blood of the child because the propranolol can cause hypoglycemia (drop in blood sugar). An important step is the photo shoot of the αιμαγγειώματος at the beginning of treatment to allow the comparison of the size of the course of treatment. In cases where there is a possibility it would be good to also measure the dimensions of the ultrasound.
How is treatment with propranolol and how long is the treatment?
Treatment with propranolol is made by mouth and the dose is gradually increased. The child continues to receive the drug until to retreat the hemangioma and then becomes a gradual discontinuation of the drug. Recently there are studies for topical administration of the drug. During the course of treatment is control of blood pressure and heart rate of the child. Infants under 2 months of age is recommended to be hospitalized in the hospital when treatment is started with propranolol. Propranolol can cause a decrease in blood sugar, therefore, the parents should administer the medicine after the meal and don’t omit meals.
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