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Original ArticleOpen Access
Ulcerated Hemangiomas : Clinical Features and Management
Wananukul S 
,
Chatproedprai S
,
Chatproedprai S SIRIW AN W ANANUKUL, M.D.*,
SUSHEERA CHATPROEDPRAI, M.D.*
Hemangioma is the most common tumor of infancy and ulceration is the most frequent com-
plication of hemangioma. The purpose of this report was to review the clinical features and manage-
ment of ulcerated hemangioma. A retrospective study of ulcerated hemangioma at the outpatient
pediatric dermatology clinic, King Chulalongkom Memorial Hospital from 1992 to 2001 was per-
formed. The medical records of 41 patients were reviewed. Twenty-eight females and 13 males were
seen with a female/male ratio of 2.2 :
1.
Superficial hemangioma was the most common type (51%).
Head and neck were the most frequently involved sites, affecting 21 cases (51%). Ulcerated heman-
giomas were found on extremities, torso, and perineum of 9 patients (22%), 6 patients (15%) and 5
patients (12%), respectively. Ulceration was developed at a mean age of 3.9 months (range, l-7
months). Conventional treatment with topical and/or systemic antibiotic was successfully used in 19
patients (46%). Oral prednisolone was used in 4 patients with large hemangiomas. The mean duration
of treatment with oral prednisolone was 12 months. Flashlamp-pumped pulsed-dye laser (FPDL) was
used in I 6 patients who failed topical and/or systemic antibiotic. Fifteen patients (94%) healed within
I to 3 treatments. Excision was done on a small superficial hemangioma on the cheek. In conclusion,
head and neck were the most common sites of ulcerated hemangioma. Topical antibiotics and/or
systemi.c antibiotics could be used as the first-line management of ulcerated hemangioma. FPDL was
very effective in the treatment of ulcerated hemangioma.
Key word : Ulcerated Hemangioma, Topical Antibiotic
SUSHEERA CHATPROEDPRAI, M.D.*
Hemangioma is the most common tumor of infancy and ulceration is the most frequent com-
plication of hemangioma. The purpose of this report was to review the clinical features and manage-
ment of ulcerated hemangioma. A retrospective study of ulcerated hemangioma at the outpatient
pediatric dermatology clinic, King Chulalongkom Memorial Hospital from 1992 to 2001 was per-
formed. The medical records of 41 patients were reviewed. Twenty-eight females and 13 males were
seen with a female/male ratio of 2.2 :
1.
Superficial hemangioma was the most common type (51%).
Head and neck were the most frequently involved sites, affecting 21 cases (51%). Ulcerated heman-
giomas were found on extremities, torso, and perineum of 9 patients (22%), 6 patients (15%) and 5
patients (12%), respectively. Ulceration was developed at a mean age of 3.9 months (range, l-7
months). Conventional treatment with topical and/or systemic antibiotic was successfully used in 19
patients (46%). Oral prednisolone was used in 4 patients with large hemangiomas. The mean duration
of treatment with oral prednisolone was 12 months. Flashlamp-pumped pulsed-dye laser (FPDL) was
used in I 6 patients who failed topical and/or systemic antibiotic. Fifteen patients (94%) healed within
I to 3 treatments. Excision was done on a small superficial hemangioma on the cheek. In conclusion,
head and neck were the most common sites of ulcerated hemangioma. Topical antibiotics and/or
systemi.c antibiotics could be used as the first-line management of ulcerated hemangioma. FPDL was
very effective in the treatment of ulcerated hemangioma.
Key word : Ulcerated Hemangioma, Topical Antibiotic
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