Characteristics and Complications of Anogenital Infantile Hemangiomas: A Multicenter Retrospective Analysis

Authors

• Justin D. Arnold, Department of Dermatology, University of California, Irvine; Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC.
• SunJung Yoon, Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD.
• Nidhi Shah, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC.
• Morgan Byrne, Milken Institute School of Public Health, Department of Epidemiology, George Washington University, Washington, DC.
• Lukas Kieswetter, Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
• Cathryn Sibbald, Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
• Irene Lara-Corrales, Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
• Neha Kinariwalla, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY.
• Maria C. Garzon, Departments of Dermatology and Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York, NY.
• Mitchell Braun, Department of Dermatology, University of California San Francisco, San Francisco, CA.
• Sonal D. Shah, Department of Dermatology, University of California San Francisco, San Francisco, CA; Department of Dermatology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH.
• Ilona J. Frieden, Department of Dermatology, University of California San Francisco, San Francisco, CA.
• Nicole Travis, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
• Carmen Liy Wong, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
• Alan N. Snyder, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC.
• Lara Wine Lee, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC.
• Erin K. Collier, Department of Medicine, Division of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
• Marcia Hogeling, Department of Medicine, Division of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
• Esteban Fernandez Faith, Division of Dermatology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
• Nicole DeVaul, Department of Anatomy and Cell Biology, George Washington University School of Medicine and Health Sciences, Washington, DC.
• A Yasmine Kirkorian, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC; Division of Dermatology, Children's National Hospital, Washington, DC. Electronic address: akirkori@childrensnational.org.

Document Type

Journal Article

Publication Date

7-12-2023

Journal

Journal of the American Academy of Dermatology

DOI

10.1016/j.jaad.2023.06.049

Keywords

LUMBAR syndrome; congenital anomalies; genital development; infantile hemangiomas; ulceration; vascular anomalies

Abstract

IMPORTANCE: Infantile hemangiomas (IHs) of the anogenital region remain poorly characterized. OBJECTIVE: To examine the distribution, ulceration rate, and associated congenital anomalies of anogenital IHs. METHODS: Retrospective study at 8 tertiary referral centers. RESULTS: A total of 435 infants with an IH of the anogenital region were enrolled (319 female, [73%]). Congenital anomalies were present in 6.4% (n=28) of infants with an anogenital IH. Segmental/partial segmental anogenital IHs ulcerated in 72% (n=99 of 138) of infants, while 45% (n=133 of 297) of focal anogenital IHs experienced ulceration (P= <.001). In a multivariable logistic regression analysis, segmental/partial segmental morphology (adjusted odds ratio [aOR] 2.70, 95% confidence interval [CI] 1.60-4.64), mixed type (aOR 3.44, 95% CI 2.01-6.07), perianal (aOR 3.01, 95% CI 1.53-6.12) and buttocks location (aOR 2.08, 95% CI 1.17-3.76), had an increased odds of ulceration. Segmental/partial segmental IHs of the genitalia were confined to distinct anatomic territories and were predominantly distributed unilaterally with a linear demarcation at the perineal raphe. LIMITATIONS: Possible selection bias given recruitment at tertiary referral centers. CONCLUSIONS AND RELEVANCE: This study improves our understanding of high-risk features of anogenital IHs and demonstrates that genital segmental/partial segmental IHs develop within distinct anatomic territories.

APA Citation

Arnold, Justin D.; Yoon, SunJung; Shah, Nidhi; Byrne, Morgan; Kieswetter, Lukas; Sibbald, Cathryn; Lara-Corrales, Irene; Kinariwalla, Neha; Garzon, Maria C.; Braun, Mitchell; Shah, Sonal D.; Frieden, Ilona J.; Travis, Nicole; Liy Wong, Carmen; Snyder, Alan N.; Wine Lee, Lara; Collier, Erin K.; Hogeling, Marcia; Fernandez Faith, Esteban; DeVaul, Nicole; and Kirkorian, A Yasmine, "Characteristics and Complications of Anogenital Infantile Hemangiomas: A Multicenter Retrospective Analysis" (2023). GW Authored Works. Paper 3088.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3088

Department

Pediatrics