Vascular hamartomas in childhood*

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Vascular hamartomas in childhood may occur in isolation, or in a more generalized form with both cutaneous and visceral involvement. Many isolated hamartomas require no active intervention, but those arising around the eye may seriously compromise developing vision, either by obscuring the visual axis, or by modifying the refractive status of the involved eye. Therefore, lesions in this site demand vigorous treatment if sight-threatening complications are to be avoided. We report our experience in treating 15 children using local steroid injections to accelerate regression of such vascular hamartomas. Seven of the children (46.7%) showed complete regression of their hemangiomas, and only two (13.3%) showed no response to the injections. Intralesional steroid injection seems to be a relatively effective, safe, and nondisfiguring method of dealing with periocular vascular malformations.

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    For patients treated with systemic corticosteroid therapy, there has been a wide range in response rate, from 29%29 to 100%.28 Meanwhile, the reported response rates in intralesional therapy have been consistently high, ranging from 77%13 to 87%.27 We have found that all hemangiomas in our series stopped growing after intralesional corticosteroid therapy.

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*

Presented at the 33rd Annual Congress of the British Association of Paediatric Surgeons, Birmingham, England, July 16–18, 1986.

1

From the Department of Paediatric Ophthalmology, Children's Hospital, Birmingham, England.

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