Skin Necrosis in Children: Vascular Causes and Angioma
(2024) Skin Necrosis — ISBN: [9783031609534], p. 443-448, published
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- Vascular anomalies are divided into vascular tumors, with infantile hemangiomas being the most common, and vascular malformations which are further subdivided into slow-flow and fast-flow malformations (Wassef et al., Pediatrics 136:e203–14, 2015). Vascular anomalies can cause ulcerations due to local ischemia provoked by a vascular steel effect induced by high flow blood velocity. This phenomenon can be seen in high flow vascular anomalies such as in the early proliferative phase of infantile hemangioma, in some congenital hemangiomas, and in arteriovenous malformations. As opposed to infantile hemangiomas, congenital hemangiomas are fully developed at birth, but can also present with ulcerations. Arteriovenous malformations are congenital lesions characterized by a direct communication between arteries and veins without the interposition of capillaries. This results in a local high flow blood velocity that can induce local ischemia leading to ulcerations. These ulcerations are typically a result of disease progression. As such, the initial treatment for ulceration focuses on managing the underlying lesion. For example, propranolol may be used for infantile hemangioma, while anti-angiogenic medications like trametinib or thalidomide may be recommended for arteriovenous malformations.
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Boon, L., Dekeuleneer, V., & Coulie, J. (2024). Skin Necrosis in Children: Vascular Causes and Angioma. In Téot, Luc (ed.) ; et al. (ed.), Skin Necrosis (p. p. 443-448). https://doi.org/10.1007/978-3-031-60954-1_68