IHs of anogenital region more likely to have associated congenital anomaly

Key takeaways:

• Congenital anomalies were present in 6.4% of those with anogenital infantile hemangiomas.
• Ulceration was most common in segmental/partial segmental anogenital infantile hemangiomas.

Infants with infantile hemangiomas of the anogenital region were more likely to have an associated congenital anomaly compared with the general population, according to a study.

“Infantile hemangiomas (IHs) occur in 2% to 5% of the infant population and may be complicated by pain, ulceration and permanent disfigurement,” Justin D. Arnold, MD, MMSc, of the University of California, Irvine, and George Washington University School of Medicine and Health Sciences, and colleagues wrote. “Previous literature suggests that anogenital IHs have an increased risk for ulceration and associated congenital anomalies; however, it is unclear which anogenital structures are most at risk for these complications and at what frequency congenital anomalies occur in association with anogenital IHs.”

Arnold and colleagues examined the distribution, ulceration rate and associated congenital anomalies of anogenital IHs in 435 infants (73% girls).

Congenital anomalies were present in 6.4% of infants with anogenital IHs, which was higher than the 3% of infants with congenital anomalies in the general population.

Ulceration occurred in 72% of infants with segmental/partial segmental anogenital IHs and 45% of infants with focal anogenital IHs.

IHs were more likely to ulcerate if they had segmental/partial segmental morphology, were of mixed type, or were located on the buttocks or perianal area.

The strongest association for congenital anomalies of all types was with lumbosacral IHs, with associations also seen for anogenital defects with penile and perianal IHs and extragenital anomalies with buttock IHs.

“Infants with a lumbosacral, penile or perianal IH should be screened for anogenital anomalies such as urogenital and anorectal malformations, and infants with a lumbosacral or buttock IH should be screened for extragenital anomalies such as myelopathy and bone, arterial or renal malformation,” the authors wrote.