Pediatric Nurse Practitioner

[Lucy125]

Have you used Aldara to treat hemangiomas in infants? Any treatment usage for different hemangiomas?

[BhumikaMD]

Hi,

Hemangiomas are connected to the circulatory system and filled with blood. The appearance depends on location. If they are on the surface of the skin they look like a ripe strawberry, if they are just under the skin they present as a bluish swelling. Sometimes they grow in internal organs such as the liver or larynx. In most cases, hemangiomas will disappear over time. They are formed either during gestation or most commonly they are not present at birth but appear during the first few weeks of life. They are often misdiagnosed, initially, as a scratch or bruise but the diagnosis becomes obvious with further growth.

Most hemangiomas disappear without treatment, leaving minimal or no visible marks. Large hemangiomas can leave visible skin changes secondary to severe stretching of the skin or damage to surface texture.The mainstay of treatment is oral corticosteroid therapy.

Hemangiomas may be treated with the 585nm pulsed dye laser (if thin), or, if thicker, with the long-pulsed Nd:YAG laser, intralesional coticosteroids, systemic steroids (if vision or the respiratory system are threatened) or, more recently, the topical immune response modifier, imiquimod (Aldara). Thinner hemangiomas respond best to treatment, so early therapy is generally best.

Other drugs such as interferon or vincristine are sometimes considered if the corticosteroids do not work. If this fails, surgical removal often becomes necessary. Blockage of the airway will often require a tracheostomy to be performed (insertion of an external airway through the front of the neck into the trachea below the level of the obstruction). Smaller raised lesions are sometimes treated with injection of corticosteroid directly into the lesion. Pulsed dye laser can be useful for very early flat superficial lesions if they appear in cosmetically significant areas or for those lesions that leave residual surface blood vessels in the case of incomplete resolution. Unfortunately raised lesions or lesions under the skin do not respond to laser.

You should visit a dermatologist and then plan out the therapy from there. If required the dermatologist will refer you to the surgeon.

You may find more informations at: http://en.wikipedia.org/wiki/Hemangioma

Hope this helped. Please let me know if you may need any more information