Are Hemangiomas Painful?
In most case , hemangiomas do not cause pain in the neck , but it is the contrary in other patients . A haemangioma can be sensitive to pressing if it appears in a wrinkle or in the axilla . If you endure from chafing in these sphere , especially in the grammatical case of rapidly grow hemangiomas , other link symptoms may occur such as bleeding , botheration or redness of the affected skin .
There are several controversial facet in the management of hemangiomas . It is pathology with a low incidence , of varying development , hardly predictable . There are presently five master objective in term of the direction :
In general , there is no doubt about treating so - called “ alarming hemangiomas ” ( those that imply a life - menace office or to the affair of nearby organs ) , which answer for for some 10 to 20 % of the total of hemangiomas . On the other script , there are hemangiomas that do not exemplify a threat a priori , and in these cases , question arise about which is the most appropriate attitude . Those who advocate belligerent direction postulate that this minimizes risks , while those who advocate conservative direction believe that better ornamental results are achieved since most hemangiomas are ego - limiting . We can then speak of two clearly different attitudes , the gravid attitude , and the aesculapian or surgical healing posture .
Expectant Attitude:
The disparager of this attitude maintain that , after reaching its maximal involvement , around 25 % of the hemangiomas present a significant disfigurement . This attitude could be indicated in modest hemangioma , located far from area with possible functional harm , and with a slow growth rate .
Therapeutic Attitude:
The treatments are divided into non - specific ( surgery , cryotherapy ) , antiangiogenic ( adrenal cortical steroid , interferon ) and antiproliferative ( chemotherapy , radiotherapy ) .
Hemangiomas that hinder the visual bloc , the airway , the audile canal and the anogenital neighborhood ( with revision of visual , respiratory , swallowing , intestinal or urinary subroutine ) should be relegate to discussion ; those with speedy growth that make or may produce pregnant tissue paper destruction or disfigurement , as well as widespread skin lesions or nonrational involvement that may lead to congestive heart failure , severe hemorrhage or coagulation disorders . The psychological impact of the hurt on the patient and kinsperson fellow member should also be count . Any therapeutic attitude must be preceded by an informed consent . The treatment must be other since they exhibit a speedy growth in the first weeks of liveliness .
Systemic Corticosteroids
Corticosteroids are for many author the handling of pick in potentially problematic hemangioma and constitute the most effective monotherapy treatment in mutual hemangioma .
Intralesional corticoid
The intralesional administration of corticosteroids is an effective treatment that manages to forefend the adverse effects of systemic corticosteroids . They are indicated in well - localized cutaneous hemangioma , mainly in the auricular pavilion , pinched backsheesh , face , eyelids , and lips .
Topical corticosteroids
Topical clobetasol has been used with safe reception and absence of adverse effects , but with inferior results to those found with intralesional corticosteroid . Interferon alfa
In the treatment of hemangiomas , IFN alfa 2 and subsequently beta 2 have been used successfully , treasure that they finish the growth and favor the decrease in size , even with large say-so than corticosteroids .
Cytotoxic
Although cytotoxic drugs are traditionally used in malignant diseases , they are sometimes dispense in biologically benignant disease with potentially serious tortuousness , such as some hemangiomas .
Bleomycin
Intralesional bleomycin has been used successfully in a serial of 14 haemangioma , with fibrosis and unwritten resolution of the lesions after 2 or 3 intervention with 2 mg bleomycin separated 30 day . It is also effective in painful hemangiomas and ulcerated haemangioma .
Ulcerated Hemangiomas
ulcer occurs in 10 % of hemangiomas and is the most frequent complication . Usually occur in places exposed to trauma , and occurs during the proliferation form , so it should not be interpret as a augury of the involution . It is associated with meaning pain , bleeding , lowly A-one infection , and residuary scratch .
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