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

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.

Department

Pediatrics

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