Hypertrophic hemangioma usually appears as pale spots at first, and then telangiectasia appears, surrounded by faint white areas. Infants and young children show two typical rapid growth periods within 1 year after birth. 1 rapid growth period is 4-6 weeks after birth, and the second is 4-5 months. Hemangiomas grow rapidly in these two periods, showing corresponding clinical symptoms, such as tenderness, ulceration, bleeding and so on. The clinical manifestations of hemangioma depend on the location, size and stage of the lesion. Superficial proliferative hemangioma often shows bright red spots or nodular lesions, while deep lesions show blue-purple or no color changes.
The regression period is usually after birth 1 year-end (12 ~1April), and the tumor growth rate slows down. The change from proliferative phase to regression phase is a gradual process, and the precursor of regression phase is that the growth rate of tumor is obviously slowed down and the texture becomes soft. After the hemangioma of skin or subcutaneous enters the regression period, the color of the tumor changes from bright red to dark gray, and the tumor gradually fades and shrinks. It is generally believed that the natural regression rate is 50% ~ 60% within 5 years old, 75% within 7 years old and over 90% within 9 years old. Most cases will go through a regression period of 2-5 years.
Hemangiomas can be divided into three types according to the depth of the site. Superficial hemangioma refers to hemangioma located in dermal layer of nipple, deep hemangioma refers to hemangioma located in reticular dermal layer or subcutaneous tissue, and mixed hemangioma has both, which should be distinguished from venous malformation. This reasonable and simplified classification method is widely recognized because it is easy to use in clinical observation.
It is found that about 62% of the patients whose lesions can subside before the age of 6 can achieve the best aesthetic effect after the tumor subsides; However, about 80% of patients with pathological changes that cannot be solved before the age of 6 years have facial scars, excessive skin and telangiectasia after the hemangioma subsides. Microscopically, a large number of mast cells appeared in the subsided hemangioma, and the vascular endothelial cells gradually lost their proliferation ability, became flat, and the blood vessels decreased. The lesion changed from a solid tumor dominated by proliferating vascular endothelial cells to a lesion dominated by fibrous adipose tissue and lumen structure. It was found that placental vascular antigens FcyRII, LeY, merosin and GLUT 1 were strongly positive in hemangioma, but negative in vascular malformation.
Congenital hemangioma is a special type of infantile hemangioma, also known as congenital non-progressive hemangioma, which is characterized by its existence at birth and complete growth. A few were found during fetal ultrasound examination. Congenital hemangioma includes two subtypes, namely, non-degenerative congenital hemangioma (NICH) and rapidly degenerative congenital hemangioma (RICH).