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Diffuse neonatal hemangiomatosis: an evidence-based review of case reports in the literature. J Am Acad Dermatol 2012 Nov;67(5):898-903 PMID: 22341467

Pubmed ID

22341467

DOI

10.1016/j.jaad.2012.01.018

Abstract

BACKGROUND: The term "diffuse neonatal hemangiomatosis" has been used historically to describe multifocal vascular lesions affecting the skin and viscera in infants.

OBJECTIVE: We hypothesized that many cases reported as diffuse neonatal hemangiomatosis did not have infantile hemangiomas (IH), but represented more recently described neonatal vascular diseases.

METHODS: A literature search was performed using PubMed database (1950-2009) with the terms "neonatal hemangiomatosis," "benign hemangiomatosis," and "diffuse hemangiomatosis." A total of 180 articles were identified. Exclusion criteria included disease onset later than 3 years of age and absence of multifocal skin involvement. In all, 73 cases were selected and categorized into 3 groups: IH/probable IH; multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT)/probable MLT; and multifocal vascular lesions, not otherwise specified.

RESULTS: Of the 73 cases, 43 had IH/probable IH, 17 had MLT/probable MLT, and 13 had multifocal vascular lesions, not otherwise specified. The clinical outcomes of these groups differed in that two of 43 (5%) patients with IH died whereas 11 of 17 (65%) patients with MLT died (odds ratio 37.6, confidence interval 5.6-387.6, P value < .0001).

LIMITATIONS: This was a literature-based meta-analysis, which inherently has limitations of incomplete and inconsistently presented information.

CONCLUSIONS: Many cases reported in the literature as diffuse neonatal hemangiomatosis represent newly described multifocal vascular anomalies such as MLT, which has a strikingly higher mortality than IH. We propose the term "multifocal infantile hemangioma-with or without extracutaneous disease" instead of "diffuse neonatal hemangiomatosis" for multiple cutaneous IH. Accurate diagnosis of multifocal neonatal vascular lesions is imperative to facilitate appropriate evaluation, treatment, and prognosis.

Author List

Glick ZR, Frieden IJ, Garzon MC, Mully TW, Drolet BA



Scopus

2-s2.0-84872679061   32 Citations

MESH terms used to index this publication - Major topics in bold

Diagnosis, Differential
Hemangioma
Humans
Infant
Infant, Newborn
Lymphangioma
Skin Neoplasms
Terminology as Topic
Viscera
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5