Colorimetric analysis of images in the follow-up of infantile hemangiomas.

BACKGROUND/OBJECTIVES: Infantile hemangiomas (IH) are common vascular tumors that appear early in life, have a rapid proliferative phase and slowly involute. There are no standardized ways to evaluate the regression of these lesions. We propose a colorimetric analysis of photographs to allow a more precise determination of IH treatment response and involution. METHODS: Patients 1-10 months of age with superficial or mixed IH were included. The lesions were managed with 0.5% topical timolol ophthalmic solution. Patients were followed for 16 weeks with 6 evaluations each. Photographic images were taken with a red and green circle placed beside each hemangioma. The photographs were treated as to equalize the size, color, and brightness among them based on the colors of the two circles. A grading scale was established based on the color of the patient skin (0) and the color of the hemangioma at the beginning of treatment (100) by pixel analysis using Adobe Photoshop® software. RESULTS: A total of 17 patients 1 to 10 months of age were included, of whom 16 were girls (94%). Fourteen lesions were superficial, and 3 were mixed IH. The median time prior to initiation of treatment was 105 days (44-232). All lesions showed some degree of clearing. The mean of lightening of color intensity observed was of 45% (17%-74%) over the period of follow-up. CONCLUSIONS: The colorimetric analysis of the digital images allowed an accurate and objective evaluation of IH clearing.

Dermatitis de contacto alérgica por tatuaje de henna / Allergic contact dermatitis from henna tattoo

Se presenta un caso de reacción de contacto por la realización de un tatuaje de henna en un paciente pediátrico y se alerta sobre las posibles complicaciones a corto y largo plazo de este procedimiento. Se trata de una niña de 12 años de edad que presentó una dermatitis de contacto después de haberse realizado un tatuaje temporario de henna. Realizó tratamiento con corticoide tópico con mejoría gradual y posterior aparición de una mácula hipocrómica residual post inflamatoria. El test epicutáneo realizado fue positivo para la parafenilenodiamina. La moda del tatuaje de henna se ha hecho común en la edad pediátrica y muchos casos de dermatitis por contacto por henna han sido descriptos en niños. Este procedimiento produce reacciones locales persistentes, erupciones símil eritema multiforme y secuelas pigmentarias, así como problemas con la futura utilización de las tinturas para el cabello debido a la sensibilización a la parafenilenodiamina. Consideramos que la comunicación de este caso es de importancia para alertar al pediatra y al dermatólogo sobre las posibles complicaciones de este procedimiento.

We present a pediatric case of contact reaction to henna tattoo, alerting of the possible short and long-term complications of this kind of procedure. We describe a 12-year-old girl with a contact dermatitis after applying a temporary henna tattoo. There was gradual improvement with the use of topical corticosteroid and evolution to residual hypochromy. Patch test was positive to paraphenilenodiamine. "Temporary tattomania" with henna is getting to the pediatric population and many cases of henna contact dermatitis have been described in children. They may present as long lasting local reactions, erythema multiform-like lesions and pigmentary sequels apart from problems with the future use of hair dyers as a result of sensitization by paraphenilenodiamine. Thus we believe that the presentation of this case is an opportunity to inform the pediatricians and dermatologists about the possibility of these complications.