Cavernous haemangioma

Strawberry naevus affects up to 1% of infants. It presents at or shortly after birth as a single red lumpy nodule that grows rapidly for the first few months. Multiple lesions can be present. They will spontaneously resolve with good cosmesis but this may take up to 7 years for complete resolution. Occasionally plastic surgery is needed after resolution to remove residual slack skin. Reassurance of parents is usually all that is required.

Treatment of cavernous haemangioma is indicated if:

• the lesion interferes with feeding or vision
• the lesion ulcerates or bleeds frequently
• the lesion is associated with high-output cardiac failure from shunting of large volumes of blood
• the lesion consumes platelets and/or clotting factors causing potentially life-threatening haemorrhage

The latter two complications are very rare and only tend to occur in large lesions with significant deep vessel involvement.

Treatment modalities include intralesional or oral corticosteroids, surgery (for selected lesions), and tunable dye laser (for treating ulceration). Alpha-interferon injections or embolization are only used for life-threatening events.

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