Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;88(2):414-420.
doi: 10.1016/j.jaad.2022.10.047. Epub 2022 Oct 28.

Incidence and clinical factors associated with ulceration in infantile hemangiomas

Esteban Fernández Faith  1 , Sonal D Shah  2 , Mitchell Braun  3 , Elena Pope  4 , Irene Lara-Corrales  4 , Patricia M Witman  5 , Katya Harfmann  5 , Flora Bradley  3 , Rohali Keesari  6 , Kenneth Jackson  7 , Alexandra Hallagan  5 , Ilona J Frieden  3
Affiliations

Incidence and clinical factors associated with ulceration in infantile hemangiomas

Esteban Fernández Faith et al. J Am Acad Dermatol. 2023 Feb.

Abstract

Background: Ulceration is an important complication in infantile hemangiomas (IHs). Prior to the use of β-blockers, the estimated incidence of this complication in a referral population was between 15% and 30%. The incidence and factors associated with ulceration have not been systematically studied since the emergence of β-blocker therapy.

Objective: Examine the incidence and clinical predictors for ulceration in IHs.

Methods: Retrospective study at tertiary referral centers.

Results: Compared with a previous large pre-propranolol cohort study, ulceration occurred at a significantly lower incidence of 11.4%. Clinical factors associated with ulceration included partial segmental morphology, location in the diaper area, and size greater than 5 cm. Higher risk of ulceration in Black patients was observed, suggesting barriers to care including delayed diagnosis and referral to specialty care.

Limitations: Retrospective design at tertiary referral centers.

Conclusion: Compared with reports before the use of β-blockers became widespread, the incidence of ulceration in IHs has decreased. However, it continues to be a relatively frequent complication of IH.

Keywords: incidence; infantile hemangioma; propranolol; risk factors; ulceration; β-blocker.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest Dr Fernández Faith is a consultant for Verrica Pharmaceuticals, Novartis, and Canfield Scientific. Dr Irene Lara-Corrales is a consultant for AbbVie, Janssen, Sanofi Genzyme, Johnson & Johnson, Pfizer, Pierre Fabre, Valeant, Loreal, Avicanna, Ipsen, Novartis, Eli Lilly, and Timber Pharma. Dr Pope is an advisory board member for AbbVie, Sanofi Genzyme, Johnson & Johnson, Pfizer, Pierre Fabre, Boehringer-Ingelheim, Novartis, and Timber Pharma. Dr Frieden is a consultant for Novartis and chairs the Data Safety monitoring board for Pfizer. Drs Shah, Witman, Harfmann, Bradley, and Hallagan and authors Braun, Keesari, and Jackson have no conflicts of interest to declare.

Publication types

Substances