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Pediatric Board Review - Dermatology

Terms in this set (88)

• Periorbital lesions: ~ 80% risk ofocular complications, including astigmatism, amblyopia, refractive errors, and, occasionally, blindness.
• Beard lesions (mandible, chin, submental): Watch for signs of subglottic hemangioma, including stridor, cough, or swallowing or respiratory difficulties. This usually occurs during the first 6 months of life and is more likely to be associated with bilateral lesions.
• Ear: Risk of obstruction in the external auditory canal, which can cause a conductive hearing loss and, if persistent, can impact/delay the development of normal speech.
• Nose and lip: These hemangiomas have a greater
tendency to ulcerate. Furthermore, these anatomic
locations carry an increased risk of significant cosmetic deformity.
• Midline lumbosacral region: Hemangiomas in this
region carry an increased risk of spinal dysraphism,
particularly when associated with other markers of
dysraphism, such as hypertrichosis, sacral dimple
or skin tag, or deviated intergluteal cleft. Evaluate
infants with these findings for underlying spinal cord abnormalities. MRI scan is the best test to rule out spinal dysraphism, but, in some centers, lumbosacral ultrasound is done first. GU anomalies also have been reported with large, lumbosacral hemangiomas.
• Multiple cutaneous hemangiomas (> 5): Can occur with visceral hemangiomas, especially of the liver
and GI tract. Most infants with> 5 have a benign
self-limited course, but a subset have severe,
disseminated, visceral involvement. These infants
are at risk for high-output congestive heart failure,
hepatic complications (including jaundice and coagulopathy), GI hemorrhage, and thyroid abnormalities.