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October 28, 1961

Management of Hemangiomas

JAMA. 1961;178(4):438. doi:10.1001/jama.1961.03040430074022

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Abstract

To the Editor:—  In an article entitled "Management of Angiomas," in The Journal (174:872 [Oct. 15] 1960), Dr. D. J. Kindel advised very early (before the 10th day of life) treatment of almost all cutaneous angiomas, including even the small strawberry marks, by using soft and ultrasoft (grenz) x-ray therapy. He used very large doses of irradiation and said there were no complications or late skin sequelae. I would like to comment as follows: (1) The overwhelming majority of the small (less than 1 cm.) strawberry marks will disappear spontaneously before the fourth year of life; thus, no therapy is necessary.(2) He recommended soft and ultrasoft (grenz) x-ray (700 r monthly for a total of 3,500-4,900 r). This is very large total dose of irradiation for angiomas, or any other benign skin condition, and late residual changes (i.e., atrophy, whitish scar, telangiectases, ugly pigmentation, ulceration, or even late

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