Early white discoloration of infantile hemangioma

A sign of impending ulceration

Sheilagh M. Maguiness, William Y. Hoffman, Tim H. McCalmont, Ilona J. Frieden

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To evaluate the relationship between early white discoloration of infantile hemangioma (IH) and ulceration. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A case series of 11 infants with early white discoloration of IH are described. An additional 55 infants with IH, aged 3 months, were evaluated retrospectively from a photograph archive to further explore the relationship between early white discoloration and presence or development of ulceration. Main Outcome Measures: Patient demographics and hemangioma size, location, and subtype are documented. Sensitivity and specificity of white discoloration in relationship to ulceration are estimated. Results: Ten of the 11 infants in the case series were girls (90%); all IHswere of segmental or indeterminate subtype. Average age at first ulceration was 2.6 months, with average age at healing 5.2 months. No intervention halted progression of ulceration. Of the 55 additional 3-month-old infants, 14 had white discoloration and 12 of these 14 had or developed ulceration (86%). When the hemangioma was either white or slightly white, sensitivity for predicting ulceration was 1.00 (95% confidence interval [CI], 0.78-1.00), with a specificity of 0.68 (95% CI, 0.51-0.81). In contrast, in infants with either slightly white or no white discoloration, the sensitivity for not developing ulceration was 0.80 (95% CI, 0.52-0.96), with a specificity of 0.95 (95% CI, 0.83-0.99), suggesting that a lack of substantial white discoloration early in infancy indicates low risk of ulceration. Conclusion: Early white discoloration of infantile hemangioma is highly suggestive of impending ulceration.

Original languageEnglish (US)
Pages (from-to)1235-1239
Number of pages5
JournalArchives of Dermatology
Volume146
Issue number11
DOIs
StatePublished - Nov 1 2010

Fingerprint

Hemangioma
Confidence Intervals
Tertiary Care Centers
Cohort Studies
Retrospective Studies
Demography
Outcome Assessment (Health Care)
Sensitivity and Specificity

Cite this

Early white discoloration of infantile hemangioma : A sign of impending ulceration. / Maguiness, Sheilagh M.; Hoffman, William Y.; McCalmont, Tim H.; Frieden, Ilona J.

In: Archives of Dermatology, Vol. 146, No. 11, 01.11.2010, p. 1235-1239.

Research output: Contribution to journalArticle

Maguiness, Sheilagh M. ; Hoffman, William Y. ; McCalmont, Tim H. ; Frieden, Ilona J. / Early white discoloration of infantile hemangioma : A sign of impending ulceration. In: Archives of Dermatology. 2010 ; Vol. 146, No. 11. pp. 1235-1239.
@article{d871e6227fde43e69d1ce4818b9ebcb4,
title = "Early white discoloration of infantile hemangioma: A sign of impending ulceration",
abstract = "Objective: To evaluate the relationship between early white discoloration of infantile hemangioma (IH) and ulceration. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A case series of 11 infants with early white discoloration of IH are described. An additional 55 infants with IH, aged 3 months, were evaluated retrospectively from a photograph archive to further explore the relationship between early white discoloration and presence or development of ulceration. Main Outcome Measures: Patient demographics and hemangioma size, location, and subtype are documented. Sensitivity and specificity of white discoloration in relationship to ulceration are estimated. Results: Ten of the 11 infants in the case series were girls (90{\%}); all IHswere of segmental or indeterminate subtype. Average age at first ulceration was 2.6 months, with average age at healing 5.2 months. No intervention halted progression of ulceration. Of the 55 additional 3-month-old infants, 14 had white discoloration and 12 of these 14 had or developed ulceration (86{\%}). When the hemangioma was either white or slightly white, sensitivity for predicting ulceration was 1.00 (95{\%} confidence interval [CI], 0.78-1.00), with a specificity of 0.68 (95{\%} CI, 0.51-0.81). In contrast, in infants with either slightly white or no white discoloration, the sensitivity for not developing ulceration was 0.80 (95{\%} CI, 0.52-0.96), with a specificity of 0.95 (95{\%} CI, 0.83-0.99), suggesting that a lack of substantial white discoloration early in infancy indicates low risk of ulceration. Conclusion: Early white discoloration of infantile hemangioma is highly suggestive of impending ulceration.",
author = "Maguiness, {Sheilagh M.} and Hoffman, {William Y.} and McCalmont, {Tim H.} and Frieden, {Ilona J.}",
year = "2010",
month = "11",
day = "1",
doi = "10.1001/archdermatol.2010.324",
language = "English (US)",
volume = "146",
pages = "1235--1239",
journal = "JAMA Dermatology",
issn = "2168-6068",
publisher = "American Medical Association",
number = "11",

}

TY - JOUR

T1 - Early white discoloration of infantile hemangioma

T2 - A sign of impending ulceration

AU - Maguiness, Sheilagh M.

AU - Hoffman, William Y.

AU - McCalmont, Tim H.

AU - Frieden, Ilona J.

PY - 2010/11/1

Y1 - 2010/11/1

N2 - Objective: To evaluate the relationship between early white discoloration of infantile hemangioma (IH) and ulceration. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A case series of 11 infants with early white discoloration of IH are described. An additional 55 infants with IH, aged 3 months, were evaluated retrospectively from a photograph archive to further explore the relationship between early white discoloration and presence or development of ulceration. Main Outcome Measures: Patient demographics and hemangioma size, location, and subtype are documented. Sensitivity and specificity of white discoloration in relationship to ulceration are estimated. Results: Ten of the 11 infants in the case series were girls (90%); all IHswere of segmental or indeterminate subtype. Average age at first ulceration was 2.6 months, with average age at healing 5.2 months. No intervention halted progression of ulceration. Of the 55 additional 3-month-old infants, 14 had white discoloration and 12 of these 14 had or developed ulceration (86%). When the hemangioma was either white or slightly white, sensitivity for predicting ulceration was 1.00 (95% confidence interval [CI], 0.78-1.00), with a specificity of 0.68 (95% CI, 0.51-0.81). In contrast, in infants with either slightly white or no white discoloration, the sensitivity for not developing ulceration was 0.80 (95% CI, 0.52-0.96), with a specificity of 0.95 (95% CI, 0.83-0.99), suggesting that a lack of substantial white discoloration early in infancy indicates low risk of ulceration. Conclusion: Early white discoloration of infantile hemangioma is highly suggestive of impending ulceration.

AB - Objective: To evaluate the relationship between early white discoloration of infantile hemangioma (IH) and ulceration. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A case series of 11 infants with early white discoloration of IH are described. An additional 55 infants with IH, aged 3 months, were evaluated retrospectively from a photograph archive to further explore the relationship between early white discoloration and presence or development of ulceration. Main Outcome Measures: Patient demographics and hemangioma size, location, and subtype are documented. Sensitivity and specificity of white discoloration in relationship to ulceration are estimated. Results: Ten of the 11 infants in the case series were girls (90%); all IHswere of segmental or indeterminate subtype. Average age at first ulceration was 2.6 months, with average age at healing 5.2 months. No intervention halted progression of ulceration. Of the 55 additional 3-month-old infants, 14 had white discoloration and 12 of these 14 had or developed ulceration (86%). When the hemangioma was either white or slightly white, sensitivity for predicting ulceration was 1.00 (95% confidence interval [CI], 0.78-1.00), with a specificity of 0.68 (95% CI, 0.51-0.81). In contrast, in infants with either slightly white or no white discoloration, the sensitivity for not developing ulceration was 0.80 (95% CI, 0.52-0.96), with a specificity of 0.95 (95% CI, 0.83-0.99), suggesting that a lack of substantial white discoloration early in infancy indicates low risk of ulceration. Conclusion: Early white discoloration of infantile hemangioma is highly suggestive of impending ulceration.

UR - http://www.scopus.com/inward/record.url?scp=78349289279&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78349289279&partnerID=8YFLogxK

U2 - 10.1001/archdermatol.2010.324

DO - 10.1001/archdermatol.2010.324

M3 - Article

VL - 146

SP - 1235

EP - 1239

JO - JAMA Dermatology

JF - JAMA Dermatology

SN - 2168-6068

IS - 11

ER -