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November 15, 2010

Characteristics of Infantile Hemangiomas as Clues to Pathogenesis: Does Hypoxia Connect the Dots?

Author Affiliations

Author Affiliations: Departments of Dermatology and Pediatrics, Medical College of Wisconsin, Milwaukee (Dr Drolet), and University of California, San Francisco (Dr Frieden).

Arch Dermatol. 2010;146(11):1295-1299. doi:10.1001/archdermatol.2010.1295

Infantile hemangiomas (IHs) are the most common tumor of infancy. Their unique clinical characteristics, including emergence after birth as a rapidly growing plaque with a bright red strawberry color or—if deeper—a soft-tissue mass with faint blue color, are distinctive and widely recognized. However, certain less typical clinical variants have been described,1 and these descriptions have been augmented by an article in this issue of the Archives by Maguiness et al2 as well as one in the September issue of the Archives by Suh et al,3 describing less common morphologic characteristics and patterns of growth. The pathogenesis of IH has been a subject of intense speculation, and several review articles have summarized recent advances and pathogenetic mechanisms.4-12 The purpose of this article is to examine the unique clinical and demographic characteristics of IH, together with recent insights into the cells of origin of hemangiomas, linking these findings into a hypothesis in which hypoxia plays a central role in the development and behavior of IH.

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