A capillary hemangioma is a bright red birthmark that can sometimes be the most noticeable feature of a little baby. They are benign endothelial cell neoplasms that are typically absent at birth and characteristically have rapid growth in infancy with spontaneous involution later in life. Capillary hemangiomas are believed to be hamartomatous proliferations of vascular endothelial cells. They are now thought to be of placental origin due to a unique microvascular phenotype shared by juvenile hemangiomas and human placenta. They will grow during the first decade and most will shrink (involutes). If they involve the eyelids, they can cover the eye and cause loss of vision (amblyopia). It is very important that children with capillary hemangiomas be seen by a pediatric ophthalmologist and eye cancer specialist as soon as it is found. Large Capillary hemangiomas may develop secondary infections and ulcerate. Bleeding is common and may be significant following injury to the hemangioma.
Capillary hemangioma is diagnosed by clinical examination. It has a typical appearance and biopsy is rarely needed. While capillary hemangiomas are benign in the sense of tumor spread, etc., their presence on the body can play host to a variety of other problems. On a purely logistical level, the bulk of an external hemangioma can interfere with breathing, eating, speaking and the like. Salmon patches are small, pink, flat spots. They are small blood vessels that are visible through the skin. They are most common on the forehead, eyelids, upper lip, between the eyebrows, and the back of the neck. They are prone to irritation and ulceration. Each lesion must be judged individually regarding the decision to treat or not to treat and the selection of a treatment mode. Surgical and medical interventions include continuous wave or pulsed dye laser, cryosurgery, and systemic glucocorticoids.
Causes of Capillary hemangioma
Hemangiomas are a common vascular birthmark. The cause of hemangioma is unknown. The color results from the extensive development of blood vessels at the site. Hemangiomas of the eyelid may interfere with the development of normal vision and must be treated in the first few months of life. On rare occasions, the size and location of hemangiomas may interfere with breathing, feeding, or other vital functions. Capillary hemangiomas are similar to strawberry hemangiomas but are more deeply situated. They may appear as a red-blue spongy mass of tissue filled with blood. Some of these lesions disappear on their own, usually as a child approaches school age.
Common causes and risk factors of Capillary hemangioma:
- The exect cause of capillary hemangioma is unknown.
Signs and Symptoms of Capillary hemangioma
Common sign and symptoms of capillary hemangioma are: an excess of blood vessels, usually veins and capillaries, in a focal area of submucosal connective tissue. Submucosal lesions are characterized by abundant, aggregated lymphoid tissue with prominent germinal centers, but the associated vessels are thin walled and the number of eosinophils is often much more marked than in epithelioid hemangioma.
Sign and symptoms may include the following :
- Small red vascular lump that bleeds easily.
- An excess of blood vessels.
- Skin markings that develop before or shortly after birth.
Treatment for Capillary hemangioma
Superficial or "strawberry" hemangiomas often are not treated. When they are allowed to disappear on their own, the result is usually normal-appearing skin. Epithelioid hemangioma responds to low-dosage radiotherapy, but not to cryotherapy or intralesional steroids. Capillary hemangiomas that involve the eyelid and obstruct vision are generally treated with injections of steroids or laser treatments that rapidly reduce the size of the lesions, allowing normal vision to develop. Large Capillary hemangiomas or mixed hemangiomas are treated, when appropriate, with oral steroids and injections of steroids directly into the hemangioma.
Treatment may include:
- Capillary hemangiomas that involve the eyelid and obstruct vision are generally treated with injections of steroids or laser treatments that rapidly reduce the size of the lesions, allowing normal vision to develop.
- Large Capillary hemangiomas or mixed hemangiomas are treated, when appropriate, with oral steroids and injections of steroids directly into the hemangioma.
- Recently, lasers have been used to reduce the bulk of the hemangiomas.
- Strangulation of the feeder vessel.
- Some physicians are using a combination of steroid injection and laser therapy together.