Do Hemangiomas Blanch?
Yes, hemangiomas do blanch and it is usually the earliest sign of a superficial infantile hemangioma. Medically speaking, blanching refers to paling or whitening of the affected skin area. It is usually an indication of the temporary hindrance of blood flow. Hemangiomas occur in different parts of the body and they can either be cutaneous or extracutaneous. Cutaneous hemangiomas occur on external sites such as the head or neck, trunk, and extremities. On the other hand, extracutaneous hemangiomas affect internal organs including the liver, larynx, gastrointestinal tract, spleen, lungs, pancreas, and adrenal glands to mention a few. Hemangiomas are common among infants, especially girls, those with low birth weight, and of Caucasian descent.
A hemangioma is usually an abnormal growth of excess blood vessels, which is a noncancerous tumor. Hemangiomas are common among infants and they appear on the skin as a red birthmark. The external hemangiomas, which appear on the skin are more common in children whereas the internal ones are most common in adults. They usually grow fast over the first few months lasting up to a year and then they enter the involution phase. The first phase is referred to as the proliferation phase. The second stage, involuting phase, is characterized by slow growth and regress for about five or seven years after which they remain unchanged. By age ten, the most hemangiomas usually have disappeared on their own and if not, they are barely visible.
Risks of Hemangiomas
Although hemangiomas are benign, they can cause some complications depending on their location, size and how fast they grow. Some of them may open up and bleed or ulcerate, which can be very painful and even cause disfiguration of the affected skin. Hemangiomas can also affect vital organs leading to difficulties in breathing, hearing, eyesight, and eating. A person may have more than one hemangioma in different areas, which sometimes is usually an indication of internal hemangiomas. The different cutaneous and extracutaneous hemangiomas can either appear separately, or both types combined. Blanching of skin is usually a vital sign as it helps identify the extent of one’s hemangioma. The coloration of a hemangioma tells a lot about the benign growth with respect to how deep under the skin surface the tumor has spread.
Signs and Symptoms of Hemangiomas
Hemangiomas start out as pink, flat areas on the skin, which soon develop into raised and bright red marks with time. They usually appear as strawberry red-colored birthmarks, with a 60% chance of manifestation on the neck or head, 22% chance on the trunk and 13% on extremities. The deeper a hemangioma is located, the darker the coloration. Those that are on the skin surface as explained have a deep red color while those deep under the skin surface have a bluish/purple color.
In terms of size, hemangiomas are usually small, but they can also grow into large tumors. This often happens during the proliferation phase, when a hemangioma undergoes rapid growth. A normal lesion can range between 0.5 to 5 cm in diameter while large ones can grow up to 20 cm in diameter. Most of them remain focal and well-circumscribed. For internal hemangiomas, they hardly exhibit any symptoms up until when they enlarge and affect affected organs. Some of the symptoms of an internal hemangioma include; loss of appetite, abdominal discomfort, nausea, and vomiting.
Conclusion
As much as they are a result of abnormal growth of blood vessels, their exact cause is unknown, thus it is difficult to prevent their occurrence. Blanching is usually the first stage of a shallow cutaneous hemangioma, followed by a shallow ulceration, then fine telangiectasias and finally a red papule surrounded by a faint halo of vascular blanching. At age 5, 50% of infantile hemangiomas are usually gone, 70% by age 7 and by age ten, they are no more. Most hemangiomas usually disappear on their own and treatment is unnecessary. However, if any complications arise before they have healed, you should seek treatment as soon as possible.
- Johns Hopkins Medicine – Hemangiomas: https://www.hopkinsmedicine.org/health/conditions-and-diseases/hemangioma
- Stanford Children’s Health – Hemangiomas: https://www.stanfordchildrens.org/en/topic/default?id=hemangioma-90-P01664
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