Maguiness Sheilagh M, Hoffman William Y, McCalmont Tim H, Frieden Ilona J
Department of Pediatric Dermatology, Children's Hospital Boston, 300 Longwood Ave, Fegan 6, Boston, MA 02115, USA.
Arch Dermatol. 2010 Nov;146(11):1235-9. doi: 10.1001/archdermatol.2010.324.
To evaluate the relationship between early white discoloration of infantile hemangioma (IH) and ulceration.
Retrospective cohort study.
Tertiary referral center.
A case series of 11 infants with early white discoloration of IH are described. An additional 55 infants with IH, aged 3 months, were evaluated retrospectively from a photograph archive to further explore the relationship between early white discoloration and presence or development of ulceration.
Patient demographics and hemangioma size, location, and subtype are documented. Sensitivity and specificity of white discoloration in relationship to ulceration are estimated.
Ten of the 11 infants in the case series were girls (90%); all IHs were of segmental or indeterminate subtype. Average age at first ulceration was 2.6 months, with average age at healing 5.2 months. No intervention halted progression of ulceration. Of the 55 additional 3-month-old infants, 14 had white discoloration and 12 of these 14 had or developed ulceration (86%). When the hemangioma was either white or slightly white, sensitivity for predicting ulceration was 1.00 (95% confidence interval [CI], 0.78-1.00), with a specificity of 0.68 (95% CI, 0.51-0.81). In contrast, in infants with either slightly white or no white discoloration, the sensitivity for not developing ulceration was 0.80 (95% CI, 0.52-0.96), with a specificity of 0.95 (95% CI, 0.83-0.99), suggesting that a lack of substantial white discoloration early in infancy indicates low risk of ulceration.
Early white discoloration of infantile hemangioma is highly suggestive of impending ulceration.
评估婴儿血管瘤（IH）早期皮肤变白与溃疡之间的关系。
回顾性队列研究。
三级转诊中心。
描述了11例患有IH早期皮肤变白的婴儿病例系列。另外从照片存档中对55例3个月大的IH婴儿进行回顾性评估，以进一步探讨早期皮肤变白与溃疡的出现或发展之间的关系。
记录患者的人口统计学资料以及血管瘤的大小、位置和亚型。估计皮肤变白与溃疡相关的敏感性和特异性。
病例系列中的11例婴儿中有10例为女孩（90%）；所有IH均为节段型或不确定亚型。首次溃疡的平均年龄为2.6个月，愈合的平均年龄为5.2个月。没有干预措施能阻止溃疡进展。在另外55例3个月大的婴儿中，14例有皮肤变白，这14例中有12例出现或发生了溃疡（86%）。当血管瘤为白色或略呈白色时，预测溃疡发生的敏感性为1.00（95%置信区间[CI]，0.78 - 1.00），特异性为0.68（95%CI，0.51 - 0.81）。相比之下，在皮肤略呈白色或无皮肤变白的婴儿中，未发生溃疡的敏感性为0.80（95%CI，0.52 - 0.96），特异性为0.95（95%CI，0.83 - 0.99），这表明婴儿期早期缺乏明显的皮肤变白提示溃疡风险较低。
婴儿血管瘤早期皮肤变白高度提示即将发生溃疡。
