Dr. Frieden said the latest thinking on the pathogenesis of hemangiomas is that their territory is determined at 4-8 weeks of gestation, before many women even know they’re pregnant. The growth afterward is volumetric, not radial. The period of explosive growth most often occurs 30-60 days after birth. Hemangiomas reach 80% of their maximum size by a mean age of 3 months. The take home point is to worry more about hemangiomas early and much less later.
“I know we all have long waiting times to see patients, but put these patients at the head of the line,” she urged.
The highest-risk infantile hemangiomas are segmental rather than localized, meaning they cover a broad anatomic region or a developmental unit. In one study, those with segmental hemangiomas were 11-fold more likely to develop complications, even after controlling for lesion size (Pediatrics 2006; 118:882-7).
Dr. Frieden serves as a consultant to Pierre Fabre.
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