Case report
Abortive or minimal-growth hemangiomas: Immunohistochemical evidence that they represent true infantile hemangiomas

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Background

Infantile hemangiomas have a characteristic natural history of rapid proliferation in the first weeks of life followed by spontaneous involution. At birth, they may be present as a precursor lesion. Sometimes one may see precursor lesions that never undergo a growth phase or that undergo minimal growth. It is unclear the exact nature of these precursor-like lesions.

Objective

We sought to describe the morphology and histopathology of these precursor-like lesions.

Methods

We describe 4 patients with macules resembling precursor lesions of hemangiomas that did not show proliferation phase or minimal growth. The histopathologic and immunohistochemical study with glucose transporter-1 was performed in all of these cases.

Results

The skin biopsy specimen showed superficial ectatic vessels that reacted with anti-glucose transporter-1 antibodies. All skin biopsy specimens exhibited capillary lobules in papillary dermis and, in two of them, in the reticular dermis and subcutis.

Limitations

This text is limited by the number of cases reported.

Conclusions

Precursor lesions of hemangioma that do not show proliferation phase or minimal growth represent, in the view of glucose transporter-1 immunoreactivity, true hemangiomas of infancy with an aborted or arrested growth cycle.

Section snippets

Methods

We included patients seen between January and December 2006 with lesions resembling precursor lesions of hemangiomas that did not show proliferation after the first few months of life. We describe the clinical features and evolution. In all cases we performed a punch biopsy of the lesions for histologic study and GLUT-1 antibody staining (DAKO Corp, Carpinteria, Calif) (dilution 1/100).

Results

Three of our patients (patients 1, 2, and 4) presented with reticulated erythematous patches with multiple fine telangiectases over pale-pink or normal-appearing skin. Patient 3 presented with a flat bluish macule with some telangiectasia and a white peripheral halo. All were present at birth (Table I). We have not observed, nor did the parents report, any further growth.

We also observed two histologic patterns, one pattern with ectatic vessels in the papillary dermis and the other with a few

Discussion

In this article, we are describing a peculiar presentation of IH. They are present at birth and, therefore, congenital, although we have avoided using this term to avoid confusion with NICH or rapidly involuting congenital hemangioma, which are clinically and histologically distinct.10, 11, 12, 13 They appear as reticulated erythematous patches (pseudocapillary malformations) with multiple fine telangiectasia on the surface; grouped telangiectases overlying normal-appearing skin; or bluish

References (14)

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Funding sources: None.

Conflicts of interest: None declared.

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