ABORTIVE, RETICULAR HEMANGIOMA or INFANTILE HEMANGIOMA WITH MINIMAL OR ARRESTED GROWTH

By Gary M. White, MD

abortive, reticular hemangioma or infantile hemangioma with minimal or arrested growth


The abortive, reticular hemangioma (ARH) is a variant of an infantile hemangioma with very little to no proliferative phase.

Clinical

A macular vascular stain with a network-like and blotchy appearance present at birth or the first week of life is characteristic [Ped Dermatol 2017;34;64]. The presences of telangiectasias, venules and a matte or dull erythema with light and dark areas is common The may appear as a solid deep erythematous patch at birth which can clinically resemble a capillary malformation.

Lipoatrophy has been associated in 13% of cases [JAAD 2015;72;828]. The lipoatrophy may be focal, semicircular, band-like or segmental. The abortive hemangioma has occurred in association with PHACE(s) syndrome [JEADV 2016;30;505].

Differential Diagnosis

Rozas-Munos et al [PD 2016;33;570] have recently described the reticulated capillary malformation (RCM) which is characterized by a reticulated, poorly defined, pale pink to light red vascular stain which may also be described as blotchy or segmental. Lesions can be extensive, sometimes affecting multiple anatomic regions. Although reticulated and blotchy morphology helps in recognition, other areas may be more homogeneous in their morphology, appearing to be more typical PWSs. The color is typically more pink-red than the blue or blue purple color of cutis marmorata telangiectatica congenita(CMTC). In addition, there is no atrophy or textural changes of CMTC. and the reticulation is less dramatic, more subtle. Some ARH show areas of vascular proliferation, e.g., raised areas whereas RCM does not have this.

Diagnosis

Biopsy is usually not necessary. If necessary biopsy confirming glut-1 positivity may be done.

Treatment

Spontaneous resolution over time is typical.

Additional Pictures

abortive, reticular hemangioma or infantile hemangioma with minimal or arrested growth abortive, reticular hemangioma or infantile hemangioma with minimal or arrested growth

abortive, reticular hemangioma or infantile hemangioma with minimal or arrested growth

References

An excellent clinical response to topical timolol gel was obtained. Abortive segmental perineal hemangioma. Dermatology Online Journal 17(10)

JAAD 2013 Volume 68, Issue 6, Pages 885.e1–885.e12

Martín-Santiago A, et al. Hemangiomas abortivos o mínimamente proliferativos. Revisión de 14 casos. Actas Dermosifiliogr. 2012;103:246–50. Nice article showing multiple pictures although ideally each picture could have been reproduced in a larger size. Their criteria for inclusion was an infantile hemangioma in which the proliferative component of the tumor accounted for less than 25% of the total surface. From seeing all the images, you get a sense for the reticular nature of this condition. In all of their cases, there was telangiectasias on normal or reddish skin.

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