Angiomas are commonly referred to as various vascular anomalies affecting approximately 10% of the pediatric population as well as vascular anomalies affecting adults (ruby angiomas, stellate angiomas, etc.).
These vascular anomalies can affect all types of vessels: capillaries, veins, arteries, lymphatic vessels, etc.
Symptoms of angiomas
Angiomas most often have the appearance of a red, bluish or even purple ball placed on the skin or lifting the skin. You can sometimes see small purplish vessels called telangiectasias.
Sometimes angiomas can be hot or even pulsatile (you can feel the heartbeat, which means they have an arterial component).
We will distinguish between angiomas in infants and adults:
The most frequent forms are infantile hemangioma and plane angioma
- Infantile hemangioma
Infantile hemangioma is a vascular tumor appearing in the first weeks of life , sometimes preceded by the birth of a clear sheet (anemic nevus) or sheet telangiectasias .
The most classic form is the “ strawberry ”, a superficial form of the hemangioma consisting of a red-purplish tumor placed on the skin, with sharp edges, with a slightly irregular surface called “nipple”.
There is also a deep form of hemangioma consisting of an arching of the skin of normal or bluish color and a mixed form combining the superficial and deep forms.
The hemangioma then usually evolves in three phases :
it increases in size and volume for up to about 6 months
it is then stable during the second semester of life
then it tends to regress most often completely in a few years . However, more or less significant sequelae are noted in 70% of cases where the angioma was located: fibro-adipose residues, areas of thinner skin, telangiectasias, etc.
It is most often localized and measures a few centimeters, but doctors will be alerted by a hemangioma of more than 5 cm² on the face of the infant, especially in the frontal or palpebral area because the latter can be associated with a malformation syndrome called PHACES, of the English acronym: anomalies of the posterior fossa of the brain, facial hemangioma, arterial anomalies intracranial and extra-cranial, congenital cardiac anomalies and aortic coarctation, ocular anomalies (Eye), Sternal and ventral anomalies
- Plane angioma
The plane angioma, classically called ” wine spot ” is a layer generally of red – purplish color more common on the face, but can be seen all over the body.
Unlike hemangioma, it is present from birth and gradually spreads as the child grows.
It can be associated with rare malformation syndromes especially in the event of limb involvement (Klippel-Trenaunay syndrome, associating a planar angioma and a gigantism of a limb)
- Stellate angioma
Small, purplish, star-shaped telangiectatic area common on the face or torso, which may regress spontaneously.
In the event of a large number of lesions, the doctor may look for a pregnancy or even a liver problem.
- Ruby angioma
Small wine-colored balls placed on the skin, very common after the age of fifty
Treatment of angiomas
Given the regression of the majority of infantile hemangiomas, the rule is to monitor the hemangioma in about 80% of cases. However, it may be useful to treat in the event of a risky location (throat, near the eye, mouth), ulceration, major aesthetic risk, etc. A beta blocker called propranolol is then most often used. , whose trade name is Hemangiol ®, instituted in pediatric hospitals in view of its cardiovascular and hypoglycemia risks in particular. Then, if tolerance is good for the infant, the treatment is continued at home for about 6 months orally during meals.
On the other second-line treatment can be offered in case of resistance or poor tolerance to propranolol: interferon, corticosteroids intravenously or by injection into the hemangioma, vincristine, laser …
The treatment of planar angioma is most often carried out by means of a vascular laser , classically as early as possible in life. It takes an average of 3 sessions to reduce the lesion.
If the patient wishes, coagulation with an electric scalpel or vascular laser can be performed.
Our doctor’s opinion on angiomas
Infantile hemangioma, affecting nearly 10% of infants, is a disease most often benign because regressive in 90% of cases at 4 years. However, this still worries parents a lot, who must be reassured about the outcome, which is often favorable. We fear only a few minor aesthetic sequelae sometimes recoverable later by laser, especially in the event of small residual vessels.
The planar angioma, for its part, also often responds quite well to the laser, especially if it is carried out early in life.