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European Handbook of Dermatological Treatments pp 1393–1402Cite as

Beta-Blockers for Hemangiomas

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Abstract

Infantile hemangioma (IH) is the most common tumor of infancy ranging from a tiny red papule to a giant mass. Its typical natural history is characterized by an early rapid growth following birth and a slow spontaneous involution which is complete before puberty but almost complete within the first 3–6 years of life. The cause underlying IH is still unknown, but the role of fetal hypoxic stress is strongly suggested as a triggering signal. A different hypothesis suggests that IH can be derived from embolized placental progenitor cells that lodge in privileged sites of the developing embryo. Alternatively, IH has been reported as an aberrant proliferation and differentiation of a primitive mesoderm-derived hemogenic endothelium regulated by the renin-angiotensin system (RAS) leading to propose angiotensin-converting enzyme (ACE) as a potential therapeutic target. While some angiogenic factors have been identified (e.g., mast cells, heparin), there are no data demonstrating a hereditary component. Immunohistochemical studies of IH confirm their vascular origin. During the proliferative phase, IH shows a high expression of cell proliferation nuclear antigen, vascular endothelial growth factor (VEGF), type IV collagen, urokinase, basic fibroblast growth factor (bFGF), and von Willebrand factor. These data demonstrate active angiogenesis and are not observed in vascular malformations.

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Notes

  1. 1.

    PHACES is an acronym: P, posterior fossa malformation (brain); H, hemangiomas; A, arterial anomalies; C, coarctation of the aorta along with cardiac defects; E, eye abnormalities; and S, sternum and/or supraumbilical abdominal raphe clefts. PELVIS, SACRAL, and LUMBAR are acronyms that denote the association of local hemangioma and malformation in the pelvic region, e.g., PELVIS = perineal hemangioma, external genitalia malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus, and skin tag. SACRAL = spinal dysraphism, anogenital anomalies, cutaneous abnormalities, renal and urologic anomalies, and angioma of lumbosacral localization. LUMBAR = lower body hemangioma and other cutaneous defects, urogenital anomalies, ulceration, myelopathy, bony deformities, anorectal malformations, arterial anomalies, and renal anomalies.

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Authors and Affiliations

  1. Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Fondazione Ca’ Granda “Ospedale Maggiore Policlinico”, Milan, Italy

    Carlo Gelmetti

  2. Fondazione Ca’ Granda “Ospedale Maggiore Policlinico”, Milan, Italy

    Riccardo Cavalli

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  1. Carlo Gelmetti
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  2. Riccardo Cavalli
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Correspondence to Carlo Gelmetti .

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Editors and Affiliations

  1. Department of Dermatology, Andreas Syggros Hospital University of Athens, Athens, Greece

    Andreas D. Katsambas  & Clio Dessinioti  & 

  2. University of Rome “G. Marconi”, Rome, Italy

    Torello M. Lotti

  3. Centro Studi per la Ricerca Multidisciplinare Rigenerativa (CSRMR), Rome, Italy

    Torello M. Lotti

  4. Unit of Dermatology, University of Pisa, Pisa, Italy

    Angelo Massimiliano D’Erme

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Gelmetti, C., Cavalli, R. (2015). Beta-Blockers for Hemangiomas. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D’Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45139-7_135

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  • DOI: https://doi.org/10.1007/978-3-662-45139-7_135

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