10.5826/dpc.1302a98
text/xml
2160-9381
2707
en
Angeles  Revert Fernandez 
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
abortive hemangioma
Dermoscopy of Abortive Hemangioma: Morphological Study of 11 Cases
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2023-04-29
2022-07-18
2023-04-29
2023-06-05
e2023098
Dermatol Pract Concept
Angeles  Revert Fernandez 
2023/04/29
10.5826/dpc.1302a98
e2023098
Department of Dermatology, Hospital Clínico Universitario, University of Valencia, Valencia, Spain
2160-9381
abortive hemangioma
en
e2023098
Huang Y, Yang J, Li Z, Zhang L, Sun L, Bi M, Wang L. Dermoscopic features of port-wine stains: A study of 264 cases. Australas J Dermatol. 2021;62(2):e201-e206. DOI: 10.1111/ajd.13470. PMID: 32955124.
Dermoscopy of Abortive Hemangioma: Morphological Study of 11 Cases
https://dpcj.org/index.php/dpc/article/download/2707/2075
                  Dermoscopy of Abortive Hemangioma:
                    Morphological Study of 11 Cases
      Leopoldo Fernández-Domper1, Esmeralda Silva Diaz1, Manuel Ballesteros Redondo1,
                  Jose Maria Martin Hernández1, Angeles Revert Fernández1


1 Department of Dermatology, Hospital Clínico Universitario, University of Valencia, Valencia, Spain



Key words: abortive hemangiomas, dermoscopy, infantile hemangiomas, vascular anomalies
Citation: Fernández-Domper L, Silva Diaz E, Ballesteros Redondo M, Martín Hernández JM, Revert Fernandez A. Dermoscopy of
Abortive Hemangioma: Morphological Study of 11 Cases. Dermatol Pract Concept. 2023;13(2):e2023098. DOI: https://doi.org/10.5826/
dpc.1302a98
Accepted: August 31, 2023; Published: April 2023
Copyright: ©2023 Fernández-Domper et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: This research was supported by the Dermatology Department of the Clinical Universitary Hospital of Valencia.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Leopoldo Fernández-Domper, MD, Department of Dermatology Hospital Clínico Universitario de Valencia,
Blasco Ibañez Avenue, 17, Valencia, Comunidad Valenciana, 46010, Spain Tel: +34636683965 E-mail: lfernandezdomper@gmail.com




Introduction                                                             diagnosed AH cases in our pediatric dermatology depart-
                                                                         ment, assessed during 2021, and we compared these findings
Abortive hemangiomas (AH) or minimal or arrested growth                  with those described for IH precursor lesions and PWS.
hemangiomas constitute a distinct subgroup of infantile                       Clinical and demographic findings are summarized in
hemangioma (IH) with a characteristic clinical presentation              Table 1. Serpinginous or tortuous vessels, punctate vessels
and natural history that are often clinically confused with              and vascular lacunae were observed in 100% of the cases
other vascular anomalies (VA) [1,2]. Dermoscopy can be                   clinically diagnosed as AH (Figures 1 and 2).
a useful tool for distinguishing VAs that may be clinically
­similar such as IH precursor lesions, port wine stains (PWS)
and, probably, AH [3]. However, dermoscopy pattern of AH
                                                                         Conclusions
has only been previously described by Toledo-Alberola et al              AH is a distinctive variant of IH present from birth in most
in 2 cases [4].                                                          cases, and, with little ability to proliferate. Although they
                                                                         could be clinically similar to other VAs they have different

Case Presentation                                                        morphologic and immunostaining patterns. On histology,
                                                                         they show dilated thin-walled vessels within the superficial
The aim of this study was to evaluate the dermoscopy find-               dermis, with a GLUT-1 positivity immunostaining demon-
ings of an AH single-center case series, comparing these                 strating a clear distinction between AH and PWS or con-
findings with those described in other clinically similar VAs            genital hemangiomas [1,2]. Dermoscopic examination may
such as IH precursor lesions and PWS. We evaluated the der-              facilitate the identification of AH for early diagnosis and
moscopy patterns and structures of 11 consecutives clinically            treatment. In our case series, serpiginous or tortuous


Research Letter | Dermatol Pract Concept. 2023;13(2):e2023098                                                                       1
2
                                                                                                                           Table 1. Clinical and demographic findings.
                                                                Patient                          Demographic characteristics                                                                          Dermoscopy findings
                                                                          Age at diagnosis                                                                                                     Serpinginous/     Puntiform   Vascular
                                                                              (years)        Age occurrence   Sex       Location      Treatment     Associate lesions     Additional tests    tortuous vessels    vessels    lacunae
                                                                  1              6             First days      M        Right leg      Timolol              -                     -                 Yes             Yes        Yes
                                                                  2              1             Unknown         M      Left buttock     Timolol     Infantile hemangioma           -                 Yes             Yes        Yes
                                                                  3              2               Birth         F        Left knee      Timolol              -             Echography and            Yes             Yes        Yes
                                                                                                                                                                             doppler
                                                                  4              2               Birth         M       Left thigh      Timolol              -                     -                 Yes             Yes        Yes
                                                                  5              0               Birth         F      Sacral fossa                          -             Spinal echography         Yes             Yes        Yes
                                                                  6              1               Birth         F     Right external    Timolol              -                     -                 Yes             Yes        Yes
                                                                                                                       malleolus
                                                                  7              1               Birth         F       Left hand       Timolol              -                Soft tissue            Yes             Yes        Yes
                                                                                                                                                                            Echography
                                                                  8             14             Unknown         M       Abdomen                              -                     -                 Yes             Yes        Yes
                                                                  9              6             First days      F      Right lumbar    Timolol +             -                     -                 Yes             Yes        Yes
                                                                                                                                      Propanolol
                                                                  10             2               Birth         M         Neck                               -                     -                 Yes             Yes        Yes
                                                                  11             1               Birth         F       Right thigh     Timolol              -                     -                 Yes             Yes        Yes




Research Letter | Dermatol Pract Concept. 2023;13(2):e2023098
Figure 1. (A) Clinically macule with telangiectasias erythematous background. (B,C) Dermoscopy image showing serpiginous or tortuous
vessels, punctate vessels and vascular lacunae.




Figure 2. (A,B) Telangiectasias on an erythematous or reticulated background. (C) Dermoscopy image showing serpiginous or tortuous
vessels, punctate vessels and vascular lacunae.



Research Letter | Dermatol Pract Concept. 2023;13(2):e2023098                                                                     3
vessels, punctate vessels and vascular lacunae was observed            retrospective case series. Pediatr Dermatol. 2019;36(1):125–131.
in 100% of the cases clinically diagnosed as AH. IH pre-               DOI: 10.1111/pde.13695. PMID: 30318787.
                                                                  2.   Rodríguez Bandera AI, Sebaratnam DF, Wargon O, Wong
cursor lesions dermoscopy features have been described as
                                                                       L-CF. Infantile hemangioma. Part 1: Epidemiology, pathogene-
large linear vessel and branching vessels with erythematous
                                                                       sis, clinical presentation and assessment. J Am Acad Dermatol.
background [5]. On the other hand, linear vessels, reticu-             2021;1379–1392. DOI: 10.1016/j.jaad.2021.08.019. PMID:
lar vessels, sausage-like vessels, dots or globules vessels and        34419524.
mixed vessels, as well as white circles and whitish veil have     3.   Piccolo V, Russo T, Moscarella E, Brancaccio G, Alfano R, Ar-
been described in PWS [6]. When comparing our findings                 genziano G. Dermatoscopy of Vascular Lesions. Dermatol Clin.
                                                                       2018;36(4):389–395. DOI: 10.1016/j.det.2018.05.006. PMID:
in AH, with those described IH precursor lesions and PWS,
                                                                       30201148.
we found these to be differential and characteristic of AH.
                                                                  4.   Toledo-Alberola F, Betlloch-Mas I, Cuesta-Montero L, et al.
As limitations, no control group was included, therefore, no           Abortive hemangiomas. Description of clinical and pathological
definitive conclusions could be made.                                  findings with special emphasis on dermoscopy. Eur J Derma-
    Dermoscopy might improve the clinical diagnosis of AH.             tol. 2010;20(4):497-500. DOI: 10.1684/ejd.2010.0959. PMID:
It might help distinguish AH from IH precursor or PWS.                 20400393.
                                                                  5.   Sun Y, Hu SCS. Dermoscopy as a diagnostic aid in the precursor
More studies including other lesions are needed to confirm
                                                                       stage of infantile hemangioma. Int J Dermatol. 2022;61(2):e54–
our findings.
                                                                       e55. DOI: 10.1111/ijd.15841. PMID: 34363688.
                                                                  6.   Huang Y, Yang J, Li Z, Zhang L, Sun L, Bi M, Wang L.

References                                                             ­Dermoscopic features of port-wine stains: A study of 264 cases.
                                                                        Australas J Dermatol. 2021;62(2):e201-e206. DOI: 10.1111/
 1. Martin JM, Sanchez S, González V, Cordero P, Ramon D. In-           ajd.13470. PMID: 32955124.
    fantile hemangiomas with minimal or arrested growth: A




4                                                                      Research Letter | Dermatol Pract Concept. 2023;13(2):e2023098
