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capillary hemangioma

ICD-10 Codes

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Description

What is Capillary Hemangioma?

A capillary hemangioma, also known as a strawberry birthmark or infantile hemangioma, is a benign (non-cancerous) tumor made up of abnormal tiny blood vessels (capillaries). It is a common vascular growth that typically appears on the outer layers of the skin.

Characteristics:

  • Capillary hemangiomas are usually present at birth but may not be visible until later in infancy.
  • They grow rapidly, often reaching their maximum size by 12 months of age.
  • These tumors can appear anywhere on the body, including the eyelids, surface of the eye, or in the eye socket.
  • In some cases, capillary hemangiomas can interfere with normal eye development and lead to vision problems.

Types:

  • Congenital hemangiomas are visible at birth.
  • Infantile hemangiomas appear later in infancy.
  • Capillary hemangiomas can also be found in other parts of the body, such as the skin, soft tissues, and bone.

Growth Pattern:

  • Capillary hemangiomas typically grow rapidly during infancy.
  • They may increase in size during Valsalva maneuvers (such as coughing or straining).
  • Half of capillary hemangiomas disappear by age five, and 90% regress without surgical treatment.

Microscopic Description:

  • Capillary hemangiomas consist of newly formed capillaries with narrow lumens and prominent endothelial cells arranged in a lobular pattern.
  • They are lined by single layers of flattened endothelial cells.

These characteristics and types of capillary hemangioma are supported by the following search results:

  • [1] Capillary hemangiomas appear on the outer layers of your skin. Infantile hemangioma (strawberry hemangioma): These blood vessel growths are common tumors of infancy, affecting up to 12% of babies by their first year.
  • [2] A capillary hemangioma ("strawberry" birthmark) is a benign (non-cancerous) tumor made up of abnormal tiny blood vessels (capillaries).
  • [3] Capillary hemangiomas are benign vascular lesions involving the skin and soft tissues that commonly occur at birth or an early age.
  • [11]

Additional Characteristics

  • A capillary hemangioma, also known as a strawberry birthmark or infantile hemangioma, is a benign (non-cancerous) tumor made up of abnormal tiny blood vessels (capillaries).
  • They are lined by single layers of flattened endothelial cells.
  • Half of capillary hemangiomas disappear by age five, and 90% regress without surgical treatment.
  • Capillary hemangiomas appear on the outer layers of your skin.
  • A capillary hemangioma ('strawberry' birthmark) is a benign (non-cancerous) tumor made up of abnormal tiny blood vessels (capillaries).
  • Capillary hemangiomas are benign vascular lesions involving the skin and soft tissues that commonly occur at birth or an early age.

Signs and Symptoms

Common Signs and Symptoms of Capillary Hemangioma

Capillary hemangiomas are typically not painful, but they can cause some noticeable symptoms. Here are the common signs and symptoms associated with this condition:

  • Red spots on the skin: Capillary hemangiomas appear as small circular or oval red spots on the skin, most often on the torso, limbs, and shoulders. They can also be bluish or purple in color.
  • Raised lesions: The affected area may feel raised or nodular to the touch.
  • No pain: Unlike some other skin conditions, capillary hemangiomas are not usually painful.
  • Multiple spots: Most people with capillary angiomas have several spots on different parts of their body.

When to Expect Symptoms

Capillary hemangiomas typically present themselves after birth, but within the first 6 months of life. In some cases, they may be present at birth (30% of cases). The symptoms usually occur in the following stages:

  • Birth: Some capillary hemangiomas are present at birth.
  • First few months: Most capillary hemangiomas appear within the first few months of life (50% by 1-2 months, and 90% by 6 months).

Important Notes

It's essential to note that while capillary hemangiomas can cause some symptoms, they are generally not a cause for concern. However, if you notice any unusual growths or changes on your skin, it's always best to consult with a healthcare professional for proper evaluation and advice.

References:

  • [4] - About one third of hemangiomas are present at birth.
  • [5] - Capillary hemangiomas usually appear in the first six months. They can be red to reddish-purple, raised lesions on the skin.
  • [12] - Presentation of capillary hemangiomas usually occurs after birth, but within the first

Diagnostic Tests

Diagnostic Tests for Capillary Hemangioma

Capillary hemangiomas can be diagnosed through a combination of clinical examination and various diagnostic tests. Here are some of the common diagnostic tests used to diagnose capillary hemangioma:

  • Clinical Examination: In most cases, a healthcare provider can diagnose a capillary hemangioma by looking at it. A thorough physical examination is usually sufficient to confirm the diagnosis.
  • Plain Radiography: Plain X-rays may be ordered to rule out other conditions that may have similar symptoms. However, plain radiography is not typically used as a primary diagnostic tool for capillary hemangiomas.
  • Ultrasonography: Ultrasonography can help establish the diagnosis and assess the extent of the lesion. It is particularly useful in cases where the hemangioma is located deep within the body or when there are concerns about potential complications.
  • CT or MRI Scan: A CT or MRI scan may be necessary to confirm the diagnosis, especially if the buildup of blood vessels is deep inside the body. These imaging studies can help determine the extent of the lesion and rule out other conditions that may have similar symptoms.
  • Skin Biopsy: In some cases, a skin biopsy may be ordered to confirm the diagnosis. This involves removing a small sample of the affected skin for further examination.

Additional Diagnostic Tests

In some cases, additional diagnostic tests may be necessary to rule out other conditions or assess potential complications. These may include:

  • Doppler Ultrasound: Doppler ultrasound can help assess blood flow within the hemangioma.
  • MRI with IV Contrast: An MRI scan with contrast dye can help determine the extent of the lesion and identify any potential complications.

References

[1] According to search result 11, capillary hemangiomas are typically diagnosed through clinical examination. [2] Search result 6 mentions that deep capillary hemangiomas may require imaging to distinguish from other conditions. [3] Search result 4 notes that ultrasonography can be helpful in establishing the diagnosis. [4] Search result 10 states that a skin biopsy may be ordered to confirm the diagnosis.

Additional Diagnostic Tests

  • Skin Biopsy
  • Ultrasonography
  • Clinical Examination
  • Doppler Ultrasound
  • Plain Radiography
  • CT or MRI Scan
  • MRI with IV Contrast

Treatment

Treatment Options for Capillary Hemangioma

Capillary hemangiomas, also known as infantile hemangiomas or strawberry nevi, are common benign tumors in children. While most lesions undergo spontaneous involution, treatment is reserved for those patients at risk for permanent visual impairment, astigmatism, or occlusion-related amblyopia.

Medications Used to Treat Capillary Hemangioma

Several medications have been used to treat capillary hemangiomas, including:

  • Propranolol: A beta blocker that has become the first-line treatment for capillary hemangiomas. It is usually taken orally and is generally safe, but may require monitoring of heart rate and blood pressure in the beginning of treatment [4][7].
  • Timolol: A gel containing timolol can be applied to the affected skin in small hemangiomas.
  • Cyclophosphamide: An alkylating agent that has been used to treat life-threatening or corticosteroid-resistant hepatic hemangiomas, but is not commonly used due to potential side effects [14].

Other Treatment Options

In addition to medications, other treatment options for capillary hemangioma include:

  • Surgery: Early surgical intervention can be considered as a primary treatment option in selected, isolated capillary hemangiomas without a significant cutaneous component [3].
  • Observation: Most patients with capillary hemangiomas require no treatment and may undergo spontaneous involution.

Important Considerations

It is essential to carefully monitor patients for potential adverse events when using medications to treat capillary hemangioma, such as bradycardia or high blood sugar. Treatment typically needs to continue until about 1 to 2 years of age [13].

References:

[3] Early surgical intervention can be considered as a primary treatment option in selected, isolated capillary hemangiomas without a significant cutaneous component. [4] Propranolol is now used as a first line of treatment for capillary hemangiomas. [7] Most hemangiomas that need medical treatment are treated with medicines called beta blockers. Propranolol is a beta blocker (part of a class of drugs used to ... [13] In small hemangiomas, you may need to apply a gel containing the medicine timolol to the affected skin. Some hemangiomas may go away if treated with propranolol, which is a liquid medicine taken by mouth. [14] The use of an alkylating agent for the treatment of capillary hemangioma was first reported by Rush in 1966, with subsequent case reports verifying the efficacy of cyclophosphamide for life-threatening and corticosteroid resistant hepatic hemangiomas.

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Differential Diagnosis of Capillary Hemangioma

Capillary hemangioma, also known as infantile hemangioma or strawberry nevus of infancy, is a common benign orbital tumor in children. However, its diagnosis can be challenging due to similarities with other conditions. Here are some key points to consider:

  • Port-wine stain (nevus flammeus): This condition can be confused with capillary hemangioma, but the cutaneous lesion in port-wine nevus is typically flatter and darker, and does not blanch with pressure [2].
  • Pyogenic granuloma: Although rare, pyogenic granuloma can present similarly to capillary hemangioma, especially in its early stages. However, it tends to be more vascular and may have a different histological appearance.
  • Infantile hemangioma: This is the most common differential diagnosis for capillary hemangioma, as both conditions share similar clinical features [6].
  • Arteriovenous malformations (AVMs): AVMs can present with similar symptoms to capillary hemangiomas, including vascular lesions and potential bleeding.
  • Lymphangioma: This condition can be mistaken for capillary hemangioma due to its similar appearance on imaging studies.

Key Features to Distinguish Capillary Hemangioma from Other Conditions

To accurately diagnose capillary hemangioma, it's essential to consider the following features:

  • Clinical presentation: Capillary hemangiomas typically present with a well-defined, vascular lesion that blanches with pressure.
  • Imaging studies: Imaging studies such as ultrasound or MRI can help differentiate capillary hemangioma from other conditions by showing its characteristic vascular pattern.
  • Histological examination: Histological examination of the tumor tissue is essential to confirm the diagnosis and rule out other conditions.

References

[1] Capillary hemangiomas are one of the most common benign orbital tumors of infancy. They are benign endothelial cell neoplasms that are [4]. [2] Differential Diagnosis. Nevus flammeus (port-wine ... can be confused with capillary hemangioma, but the cutaneous lesion in port-wine nevus is typically flatter and darker, and does not blanch with pressure [2]. [6] The most common and, from the therapeutic point of view, highly relevant differential diagnosis is infantile hemangioma, which can also show a segmental ... [6] [11] Capillary hemangiomas of infancy are the most common benign orbital neoplasms in children. Differential Diagnosis. Based on the location and size of the lesion they may be mistaken for other benign conditions such as lymphangioma, arterio-venous malformations, mucocele or meningocele [11].

Additional Information

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