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Lip infantile hemangiomas grew in distinct locations, patterns

Infantile hemangiomas of the lip displayed a preference for growing in distinct, nonrandom locations and patterns, allowing for prediction of location and possible clinical outcomes, according to study results.

Researchers retrospectively reviewed medical records of patients with facial infantile hemangiomas (IHs) of the upper or lower lip during an 8-year period. Using photographs and a lip schematic, the researchers encoded each lesion with a number reflecting its location, with the number shared by other lesions found at the same site. Lesion characteristic frequencies, functional and aesthetic factor complications, airway obstruction and therapy also were noted.

Of the 1,916 IHs diagnosed, 342 patients (age at presentation, birth to 8 years; 80.4% female) had 360 lip IHs. Focal lesions were present on 213 patients (62.3%), while 147 segmental lesions were found on 129 patients (37.7%). The lower lip was the most common site of focal lesions (46%), while cutaneous segmental lesions occurred most frequently on the mandibular segment (51%), with 40% of these patients having airway involvement.

The vermiliocutaneous junction was involved most commonly in the anatomical distortions of the lip (61.5%). Horizontal and vertical lip lengthening occurred in 28.7% and 31% of patients, respectively. One hundred thirty-seven patients had ulceration and scarring; 33.6% of the patients displayed an association with segmental mandibular IHs, and 22.5% had focal IHs of the lower lip.

Researchers said they used previously described surgical procedures for each affected zone.

“Although focusing on lip IHs, our findings support previous observations that demonstrate the predilection of facial IHs to grow in distinct locations and patterns,” the investigators concluded. “The distribution seems to be related to the embryologic development of the upper and lower lips. These anatomical patterns allow for the prediction of anatomical location, structural distortion and possible clinical outcomes [and are] relevant when planning medical and surgical treatment for these children.”

Disclosure: The researchers report no relevant financial disclosures.