Experts update map of facial segmental infantile hemangiomas

The maxillary and mandibular segment borders of facial infantile hemangiomas were redefined after a review of more than 500 case-patients’ photographs, according to a study.

“Recognizing segmental infantile hemangioma (IH) patterns is important for risk stratification and provides clues to pathogenesis,” Alyson A. Endicott, MD, of the department of dermatology at the UCSF School of Medicine at University of California, San Francisco, and colleagues wrote.

The researchers noted that segmental hemangiomas had previously been mapped to four facial regions, with three of those regions corresponding to known facial metameres. However, in the current retrospective cohort study, they refined these maps of facial segmental IHs and defined a possible new pattern of segmental hemangiomas in the scalp. In addition, indeterminate hemangiomas were studied as a function of known segmental patterns.

Data from four pediatric dermatology centers underwent analysis. The study included photographs of patients aged younger than 12 years. The researchers used heat map densitometry to identify patterns and make comparisons of various segmented and indeterminate hemangiomas.

Ultimately, the researchers mapped 549 IHs.

Results showed agreement between previous and novel segmental maps regarding the borders of the frontotemporal and frontonasal segments.

However, differences were reported for the maxillary and mandibular segment borders. These differences were seen, specifically, in the preauricular skin. Previous findings showed that “preauricular skin segregated with the mandibular rather than the maxillary segment,” according to the researchers.

Further analysis showed that indeterminate hemangiomas “occurred within and respected the same borders” as segmental counterparts. Those that were observed on the lateral scalp were seen most frequently in a C shape that extended from the posterior auricular region.

“This cohort study refines the previous map of facial segment IHs and describes a new segmental scalp IH pattern,” the researchers concluded. “It highlights that indeterminate IHs are actually partial segmental IHs because they respect anatomic boundaries of facial segments.”