Yu L, Li L L, Yan P, Deng L, Gan X L, Yao X J, Zhu Z H, Zhang T D
Department of Dermatology, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
Department of Endocrinology, Penglai People's Hospital, Yantai, China.
J Eur Acad Dermatol Venereol. 2020 Sep;34(9):2135-2139. doi: 10.1111/jdv.16331. Epub 2020 Apr 27.
Infantile haemangiomas (IHs) involving the lip are of special concern because of the susceptibility of complications, including ulceration, obstruction and disfigurement. The available data for the relationship between their clinical characteristics and ulcerations are limited.
To describe the clinical characteristics of lip IHs and to evaluate the main risk factors for ulceration.
A retrospective study was designed that included infants with lip IHs during an 8-year period, the clinical data of participants were collected, and univariable and multivariable logistic models were used to determine the relationships between the clinical characteristics of lip IHs and ulcerations. Location, size and type were investigated as potential independent factors influencing the development of ulceration.
A total of 69 lip IHs were identified including 40 girls and 29 boys. Ulcerations were found in 37 (53.6%) lip IHs. Lip haemangiomas experiencing ulceration had a mean size (SD) of 3.49 (2.82) cm compared with 1.08 (0.96) cm for those without ulceration. Twenty-eight (52.8%) of the 53 localized haemangiomas and 9 (56.3%) of the 16 segmental haemangiomas experienced ulcerations. Univariable analyses of all investigated factors revealed significant associations of location and size with increased risk of ulceration, and these significant associations remained after adjusting for sex and age [OR 8.61 (95% CI, 2.24-33.13) and 2.62 (95% CI, 1.46-4.72), respectively]. The duration before ulceration was between 4 and 70 days after the occurrence of lip IHs, with a median of 28 (19.41) days. Most ulcers occurred within 45 days of IH occurrence.
Ulceration is a common complication of lip IHs at an earlier stage. A swollen with pale or bright crimson appearance of the lip IH surface could be an important signal of subsequent ulceration. Location of the IH on the lower lip and lip IH size are risk factors for the occurrence of ulceration.
累及唇部的婴儿血管瘤（IHs）因其易引发包括溃疡、梗阻和毁容等并发症而备受关注。关于其临床特征与溃疡之间关系的现有数据有限。
描述唇部IHs的临床特征并评估溃疡形成的主要危险因素。
设计了一项回顾性研究，纳入8年间患有唇部IHs的婴儿，收集参与者的临床数据，并使用单变量和多变量逻辑模型来确定唇部IHs的临床特征与溃疡之间的关系。研究部位、大小和类型作为影响溃疡发生的潜在独立因素。
共识别出69例唇部IHs，其中女孩40例，男孩29例。37例（53.6%）唇部IHs出现溃疡。发生溃疡的唇部血管瘤平均大小（标准差）为3.49（2.82）cm，未发生溃疡的为1.08（0.96）cm。53例局限性血管瘤中有28例（52.8%）、16例节段性血管瘤中有9例（56.3%）发生溃疡。对所有研究因素的单变量分析显示部位和大小与溃疡风险增加显著相关，在对性别和年龄进行校正后，这些显著相关性依然存在[比值比分别为8.61（95%置信区间，2.24 - 33.13）和2.62（95%置信区间，1.46 - 4.72）]。溃疡发生时间在唇部IHs出现后的4至70天之间，中位数为28（19.41）天。大多数溃疡在IHs出现后的45天内发生。
溃疡是唇部IHs早期常见的并发症。唇部IHs表面肿胀且呈苍白或鲜红色外观可能是随后发生溃疡的重要信号。IHs位于下唇以及唇部IHs的大小是溃疡发生的危险因素。
