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  • Title: Guidelines of care for cutaneous haemangiomas.
    Author: Chan YC, Giam YC.
    Journal: Ann Acad Med Singap; 2005 Jan; 34(1):117-23. PubMed ID: 15726230.
    Abstract:
    INTRODUCTION: Haemangiomas are common benign tumours of the vascular endothelium. They are extremely heterogenous clinically, with size, location and rate of proliferation having a significant effect on the risk of complications. MATERIALS AND METHODS: The available evidence in the literature was evaluated using the grading system currently employed by the Ministry of Health, Singapore. RESULTS: An uncomplicated haemangioma can be observed for spontaneous involution. However, some haemangiomas may be life- or function-threatening, or have associated structural anomalies. Corticosteroids may be used topically, intralesionally or systematically. Interferon alpha, vincristine and cyclophosphamide are therapeutic options for complicated haemangiomas which do not respond to corticosteroids. Vascular-specific pulse dye laser therapy may be considered for superficial haemangiomas, ulcerated haemangiomas or post-involution sequelae like telangiectasia. The mainstay of therapy for ulcerated haemangiomas is good local wound care, analgesics and treatment of secondary infection. A periorbital haemangioma that obstructs the visual axis or exerts pressure on the globe is an ocular emergency. Systemic corticosteroids and patching of the unaffected eye should be considered. CONCLUSIONS: Medical practitioners should be aware of available therapeutic options for life- or function-threatening haemangiomas. Treatment must be individualised and referral to the relevant specialist should be considered in patients with complicated haemangiomas.
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