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Abstract Infantile Haemangiomas (IH) are benign vascular tumors composed of proliferating endothelial cells without dysplastic vessels. Haemangiomas are the most common tumors of infancy and occur in nearly 10% of children aged less than 1 year, with a female predominance. They may occur in various anatomic sites, the most common being the head and neck. Infantile haemangiomas are characterized by unclear appearance at birth, but undergo rapid and intermittent growth throughout the first year of life. By the age of 5 years usually 50% of the lesions have involuted. This increases to nearly 70% by the age of 7 years and about 90% by the age of 9 years. Nevertheless, in 40–50% of all affected children telangiectatic cutaneous vessels, fibrous-fatty tissue or scar formations can be observed as a residue of the lesions Hemangiomas are categorized as superficial, deep or combined. Depending on the size and location of the hemangioma, many serious problems can occur. For example, eyelid IH can cause deprivation amblyopia, a subglottic IH can compromise the airway, and extremely large IH can cause high output congestive heart failure. Some IH ulcerate and bleed and some if left untreated can lead to disfigurement that is difficult to correct later in life. The appropriate treatment modality depends on the location and the type of haemangioma, the age of the patient and the presence of complications. Most haemangiomas are benign in their course and are self-limiting, after the initial proliferative phase (3 to 12 months). The correct management of IH is generally expectant in the absence of complications or sustained cosmetic handicap. Active treatment may be necessary when any of the complications occur or the cosmetic handicap is significant. Treatment modalities for IH can be classified into 4 main categories: pharmacotherapy, chemotherapy, laser therapy, and surgical excision. Corticosteroids are the first line of therapy for the treatment of complicated hemangiomas; they may be administered topically, intralesionally, or orally. Systemic steroids have proven effectiveness, but the risks of long-term and high dose use include growth disturbances and immune system dysfunction as well as ulcerations up to severe tissue loss. Moreover, there are cases of fast growing infantile hemangiomas which show no response to steroid therapy. |