Vascular Lesions are abnormalities of vascular elements that appear at birth or in infancy. Studies of the cellular features of cutaneous vascular lesions have identified two general types: Hemangiomas and Vascular Malformations. Hemangiomas are vascular tumors that grow by cellular proliferation. Vascular malformations are tumors created by errors in morphogenesis or cell type.
Hemangiomas
Hemangiomas are the most common benign tumor in infancy, occurring in 1% to 2% of all newborns. Hemangiomas are generally not recognized until they begin to grow after several weeks or months of life. Most occur as a single lesion and most occur on the head (60%). A hemangioma is made up of endothelial cells, the kind that forms the lining of blood vessels. If close to the skin surface it will appear raised and crimson, like a strawberry or raspberry. If deep to the surface the skin may be smooth with a bluish hue. Hemangiomas undergo a phase of proliferation or rapid growth until the child is 6 to 10 months old, and then they slowly involute or disappear. By age 5 to 7 years there may be little sign of the original growth in many children, and in other children a fibrofatty mass with pale and wrinkled skin may be left.
Critical structures that may be involved include:
- Orbit
- Eyelids
- Ear Canal
- Mouth
- Airway
Complications such as ulceration, bleeding, disfigurement, and interference with vision, hearing, eating or breathing require active treatment. In these complex cases, steroid treatment, laser surgery, or reconstructive surgery may be needed.