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IHE locations correlate with supply areas of embryonic arteries
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The location of infantile hemangiomas on the extremities in children may be related to embryonic arterial supply area variants during fetal development, according to recent data.
“We hypothesize that, similar to PHACE syndrome, variant arterial anatomy during embryo fetal development may contribute to temporary regional hypoxia, thus stimulating angiogenesis resulting in [infantile hemangiomas on the extremities (IHE)],” Antonia Reimer, MD, from the department of pediatric dermatology at Catholic Children’s Hospital Wilhelmstift in Hamburg, Germany, and colleagues wrote. “Prospective studies of vascular anatomy in children with IHE, using noninvasive methods such as Doppler ultrasound and magnetic resonance angiography, are needed to corroborate our hypothesis.”
Reimer and colleagues evaluated 109 pediatric patients with segmental IHE and infantile hemangiomas with minimal or arrested growth (IH-MAG) at a pediatric dermatology department between 2002 and 2015. The researchers mapped the hemangiomas and evaluated any patterns that emerged among patients.
They found that 105 patients had unilateral IHE. Sixty-eight patients had upper extremity IHE and 41 patients had lower extremity IHE. Segmental IHE were more common, comprising 83.8% of upper extremity IHE and 56.1% of lower extremity IHE. The remaining 16.2% of upper extremity IHE were IH-MAG, as were the remaining 43.9% of lower extremity IHE.
Reimer and colleagues noted that ulceration occurred in 5.5% of patients.
“IHE appear to follow certain patterns that do not correspond to dermatomes, neural supply or Blaschko lines,” the researchers wrote. “Our data suggest a possible correlation between location of IHE and the supply areas of embryonic arteries and their variants.” – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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