What is an angioma and what causes it?
Angiomas are vascular lesions that small children present and are a frequent reason for consultation. Actually, under the term angioma most parents refer to red spots on the surface of the skin of children that bring me to the consultation. But there are two fundamental types of red spots in a small child: vascular malformations, which are congenital, appear and are present from the moment the child is born; and hemangiomas that are actually of tumoral origin, not malformative and very often are not seen at the time the child is born but appear later in the first weeks of life and proliferate to become more or less striking in function of the size of the hemangioma. We do not know the cause of one or the other, neither of the vascular malformation nor of the hemangioma as tumor proliferation. There are many theories that speak of hypoxic phenomena as the origin of the hemangioma. In the case of vascular malformations it is possible that in some cases there are genetic disorders, but until very recently we know the fundamental cause that causes them.
How does it manifest itself and what symptoms does it present?
As I said before, most of the time hemangiomas manifest as red spots on the surface of the skin. When it comes to vascular malformations, they can be lumps without a different shade from normal skin or they can be of a bluish tone, this depends, of course, on each lesion. It depends on each case and each child, and even on the location on the body surface.
How is the diagnosis made?
Diagnosis of vascular malformations and hemangiomas is usually immediate in most cases because dermatologists who work with children fundamentally know how to recognize them very well. Sometimes it is necessary to do some specific test, a skin ultrasound to see if there is vascular flow and what type of flow exists. We can also sometimes need an MRI to see the extension in depth of the malformation. But as I say, in the vast majority of cases the diagnosis is visual and immediate.
What is the treatment?
The treatment of vascular injuries in children depends a lot on the type of injury that is. In some cases it is very simple and we do not even need to do any treatment, because the hemangiomas, these tumor lesions of which I spoke at the beginning return by themselves. Initially they grow but when the child has more or less a year of life they begin to flatten, to lose the coloration and finally they are practically imperceptible, or there is a residue that can be surgically resolved. In the case of vascular malformations, it is different. These injuries are stable, do not heal by themselves and do not have such a simple treatment. Sometimes when they are very superficial the laser can be used and also in selected cases surgery can be performed. We have now for the hemangiomas a new treatment that is oral propranolol, which we have been using for approximately four or five years and which is giving exceptional results in the children who are treated. However, like all oral treatment, you have to select the patient well and decide if it is truly worthwhile or not to treat an injury that will disappear on its own.