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December 21, 2020
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Screen for infantile hepatic hemangioma in infants with more than five IHs

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Infants who have at least five infantile hemangiomas should be screened for infantile hepatic hemangioma, according to a study published in Journal of the American Academy of Dermatology.

“It is well known that the presence of multiple cutaneous infantile hemangiomas (IHs) could be associated with IHH,” Yi Ji, MD, PhD, of the division of oncology, department of pediatric surgery, West China Hospital of Sichuan University, and colleagues wrote. “Ultrasonography screening for IHH in patients with multiple cutaneous IHs may allow for earlier treatment and closer surveillance before life-threatening progression occurs, preventing complications and reducing mortality.”

The prospective, multicenter study included 676 patients aged 0 to 9 months old with at least three cutaneous IHs and 980 patients with one to two IHs. Abdominal ultrasonography was completed in all cases.

Infantile hepatic hemangioma (IHH) was found in 31 patients, with the incidence of IHH being higher in subjects with five to nine cutaneous IHs compared with those with fewer than five cutaneous IHs (8.3% vs. 0.4%, P < .001; OR 21.833; 95% CI, 8.271-57.636).

The trend continued in patients with 10 to 30 cutaneous IHs compared with those with five to nine (24.1% vs. 8.3%, P = .011; OR 3.5; 95% CI, 1.273-9.622) and those with more than 30 IHs (33.3%) compared with 10 to 30 (24.1%), but this difference was not significant.

The results show patients with more than five IHs should be screened for IHH, according to the authors.

“Increased awareness of IHH screening will allow for earlier diagnosis and potential curative treatment,” they wrote. “Abdominal ultrasonography is recommended for children younger than 9 months of age who present with five or more cutaneous IHs.”