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      Congenital Progressive Mutilating Hemangioma

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          Abstract

          A 73-year-old male patient was admitted with symptoms of decompensated cardiac and pulmonary insufficiency with long-lasting history. A tumor-like formation was observed within the clinical examination, covering the whole skin of the nose, paranasal region of the left part of the face, as well as the upper and lower left eyelids. The lesion was with yellow to brownish surface and dark-reddish to violet discolored peripheral area, composed of nodular formations, smooth central surface and firm texture on palpation. The histopathological examination verified the diagnosis of hemangioma, which had been congenital, regarding the patient’s history, treated surgically about 50 years ago, with signs of recurrence. The presented patient had been treated surgically at the age of 20, without medical evidence of the type of the performed excision. The recurrence occurs almost 50 years later, at the age of 78. To the best of our knowledge, this is the first reported recurrence of infantile hemangioma, treated surgically almost 50 years ago.

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          Management of Infantile Hemangiomas: Current Trends

          Infantile hemangiomas (IH) are common vascular tumours. IH have a characteristic natural course. They proliferate rapidly during the early infantile period followed by a period of gradual regression over several years. Most of the uncomplicated IH undergo spontaneous involution, with a small proportion of cases requiring intervention. These are children with IH in life-threatening locations, local complications like haemorrhage, ulceration and necrosis and functional or cosmetic disfigurements. Systemic corticosteroids have been the first line of treatment for many years. Recently, non-selective beta-blockers, such as oral propranalol and topical timolol, have emerged as promising and safer therapies. Other treatment options include interferon α and vincristine which are reserved for life-threatening haemangiomas that are unresponsive to conventional therapy. This review mainly focuses on the current trends and evidence-based approach in the management of IH.
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            Surgical outcome in patients treated for hemangioma during infancy, childhood, and adolescence: a retrospective review of 44 consecutive patients.

            Hemangiomas are the most common tumors in infancy and childhood and account for 7% of benign soft tissue tumors. Diagnosis is usually made in infancy or childhood. There are only a few reports on the surgical treatment of these lesions, likely because the lesions are quite vascular, have a tendency to infiltrate into the muscle and other tissues, and the recurrence rate is quite high.
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              Author and article information

              Journal
              Open Access Maced J Med Sci
              Open Access Maced J Med Sci
              Open Access Macedonian Journal of Medical Sciences
              ID Design 2012/DOOEL Skopje (Republic of Macedonia )
              1857-9655
              15 June 2017
              11 June 2017
              : 5
              : 3
              : 395-396
              Affiliations
              [1 ] “Onkoderma” - Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
              [2 ] Department of Dermatology and Venereology, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
              [3 ] University of Rome, “G. Marconi”, Rome, Italy
              [4 ] Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, 01067 Dresden, Germany
              [5 ] Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
              [6 ] Institute for Bioethics & Health Policy; Department of Dermatology & Cutaneous Surgery; Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine - Miami, FL, USA
              [7 ] Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
              Author notes
              [* ] Correspondence: Prof. Dr. Georgi Tchernev. Specialist for Dermatology, Venereology and Dermatologic surgery. “Onkoderma”- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria; Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria. E-mail: georgi_tchernev@ 123456yahoo.de
              Article
              OAMJMS-5-395
              10.3889/oamjms.2017.098
              5503742
              033bb754-6876-49a2-9c78-76f96365cbb3
              Copyright: © 2017 Anastasiya Chokoeva, Radica Sokolova, Torello Lotti, Uwe Wollina, Serena Gianfaldoni, Jacopo Lotti, Katlein França, Georgi Tchernev.

              This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).

              History
              : 09 May 2017
              : 18 May 2017
              : 19 May 2017
              Categories
              Letter to the Editor

              infantile hemangioma,plastic surgery,mutilation,beta blockers,topicall approach

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