Characteristics of noninvoluting congenital hemangioma: a retrospective review.

BACKGROUND: Noninvoluting congenital hemangioma (NICH) is a distinct vascular tumor of infancy. OBJECTIVE: We describe the clinical characteristics, histopathology, imaging, and natural history of NICH and compare our findings with previous reports. METHODS: We conducted a retrospective review of charts and photographic databases from 2 vascular anomaly centers over a 15-year period. RESULTS: Thirty cases of NICH were identified. All patients had fully formed vascular lesions at birth that demonstrated a nonprogressive course. The trunk and lower extremities were preferred sites and there was a female predominance. Thirteen of 30 patients reported pain. Focal necrosis and scarring was seen in a minority. Doppler studies, when performed, confirmed high vascular flow. Microscopic evaluation of 4 excised lesions showed lobular areas of endothelial cell proliferation directly adjacent to ectatic malformed vessels. Immunohistochemical studies demonstrated absence of glucose transporter-1 protein expression in every case. Wilms tumor-1 positivity was observed in lobular areas. The larger vessels did not stain with Wilms tumor-1, but some displayed D2-40 positivity. LIMITATIONS: Patients were referred to university-based pediatric vascular anomaly centers, with potential bias toward more severe or extensive cases. CONCLUSIONS: This retrospective study highlights the unique clinical and histopathologic features of NICH.

Allergic contact dermatitis in children: common allergens and treatment: a review.

PURPOSE OF REVIEW: The following study reviews the recent literature pertaining to allergic contact dermatitis (ACD) in the pediatric population. This study also provides an overview of the most common allergens and discusses various therapeutic modalities. RECENT FINDINGS: The pathophysiology of ACD is intricate and multifaceted, resulting in a characteristic, delayed inflammatory response. Although commonly recognized in adults, its existence in the pediatric population was questioned. Recent literature suggests that pediatric ACD exists and is more common than previously recognized. The diagnosis relies on the clinical presentation combined with appropriate use and interpretation of a patch test. Although many studies have investigated ACD in children, few have documented the relevance of positive patch test reactions until recently. The most current prevalence estimates of positive patch test reactions range from 14 to 70% of children patch tested. Although that range is broad, these studies have demonstrated the relevance of positive reactions and confirmed ACD as a disease entity in children. SUMMARY: ACD is a previously underrecognized disease process in the pediatric population that can manifest as a serious dermatologic challenge for both patients and physicians. This review will address the prevalence, diagnostic methods, frequent allergens and treatment options in pediatric ACD.

Developing a Multidisciplinary Vascular Anomalies Clinic and Reviewing the Radiologist's Clinic Role.

Cutaneous vascular anomalies can be challenging to diagnose and treat given their rare presentation and that they do not always fall under the purview of a specific medical specialty. Patients with cutaneous vascular anomalies are best managed in vascular anomalies clinics, but to our knowledge, no reported publications exist on how to develop such a clinic. In this article, we describe the specifics steps our institution took to create a vascular anomalies clinic and discuss how it benefitted our patients and referring providers. We also highlight the roles of the diagnostic and interventional radiologist within a vascular anomalies clinic.