Reticular infantile hemangiomas with minimal or arrested growth associated with lipoatrophy

Abstract

Background: Reticular infantile hemangioma (RIH) with minimal or arrested growth (MAG) is an underrecognized variant of infantile hemangioma (IH).

Objective: We describe a new clinical subtype of RIH-MAG associated with lipoatrophy.

Methods: The medical charts and serial clinical photographs and imaging studies of 53 children given a diagnosis between 2004 and 2013 labeled as "abortive," "minimal or arrested growth," "reticular," or "congenital" hemangiomas were reviewed in the departments of dermatology and infantile plastic surgery of 2 French university hospital centers.

Results: Seven children were identified with RIH-MAG associated with lipoatrophy. There were 3 main patterns: (1) a focal cutaneous depression; (2) semicircular lipoatrophy with a horizontal bandlike depression; and (3) segmental soft-tissue atrophy. One case of segmental RIH-MAG of the back of the foot was associated with genital abnormalities reminiscent of perineal hemangioma, external genitalia malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus, and skin tags (PELVIS) syndrome.

Limitations: The limitations were the retrospective study design, the small number of cases, and selection bias based on recall and photography.

Conclusion: RIH-MAG with lipoatrophy is an uncommon variant of IH that may be confused with other vascular anomalies, particularly capillary malformation, focal and atrophic cutis marmorata congenita telangiectatica, and rapidly involuting congenital hemangioma with lipoatrophy as a sequela.

Keywords: abortive hemangioma; arrested growth hemangioma; infantile hemangioma; lipoatrophy; lipodystrophy; minimal hemangioma; reticular hemangioma.