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Editorial |

Characteristics of Infantile Hemangiomas as Clues to Pathogenesis Does Hypoxia Connect the Dots?

Beth A. Drolet, MD; Ilona J. Frieden, MD
Arch Dermatol. 2010;146(11):1295-1299. doi:10.1001/archdermatol.2010.1295.
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Infantile hemangiomas (IHs) are the most common tumor of infancy. Their unique clinical characteristics, including emergence after birth as a rapidly growing plaque with a bright red strawberry color or—if deeper—a soft-tissue mass with faint blue color, are distinctive and widely recognized. However, certain less typical clinical variants have been described,1 and these descriptions have been augmented by an article in this issue of the Archives by Maguiness et al2 as well as one in the September issue of the Archives by Suh et al,3 describing less common morphologic characteristics and patterns of growth. The pathogenesis of IH has been a subject of intense speculation, and several review articles have summarized recent advances and pathogenetic mechanisms.412 The purpose of this article is to examine the unique clinical and demographic characteristics of IH, together with recent insights into the cells of origin of hemangiomas, linking these findings into a hypothesis in which hypoxia plays a central role in the development and behavior of IH.

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Figure 1

Precursor lesion of infantile hemangioma in a newborn infant.

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Figure 2

Telangiectatic plaque with bright red papules “sprouting” from the telangiectasia on the arm of a 7-day-old infant.

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