Out of the Fruit bowl - Strawberries and Cherries
"Infants are often referred to see the dermatologist... when the hemangioma is located
in the high risk area..."
Andrea M. Dominey, MD
Many medical conditions are characterized by culinary descriptions. Dermatologic conditions are no exception. Two common vascular lesions seen by dermatologists include strawberry hemangiomas, also called infantile hemangiomas, and cherry angiomas, also known as cherry hemangiomas or senile hemangiomas.
Infantile hemangiomas arise in about 10% of infants. They occur more often in premature infants and females. They may be apparent at birth or appear within the first few weeks of life. Initially they are pale to light pink patches of skin that rapidly darken and begin to form into lump, bumps, or plaques. They grow rapidly during the first 6 months of life. Between 6-12 months of life, growth slows and then over 2-10 years, the hemangioma will resolve. Depending on the size, thickness, and location of the hemangioma, they may leave behind no visible skin changes, small patches of dilated blood vessels, or loose soft doughy skin.
Many hemangiomas come and go on their own without complication and do not need treatment. Other hemangiomas require intervention. These include hemangiomas that grow fast enough to break down and form open sores. They are often located in the folds of the neck, armpits, groin and diaper area. High risk areas also include the eye, nose, lip and ear. Rarely, large hemangiomas affecting the face, neck, and diaper area can be associated with internal malformations.
Infants are often referred to see the dermatologist by their pediatrician or family doctor when the hemangioma is located in a high risk area such as the head and neck, diaper area, or if the hemangioma is at risk for residual cosmetic abnormalities or is ulcerated.
Fortunately for babies that require intervention, treatment has advanced during the last 10 years. Oral and topical beta blockers are helpful in halting the growth of these vascular lesions. Initial monitoring for side effects is done in conjunction with the primary care provider. Length of therapy varies but generally ranges from 6-12 months. Other treatments include oral steroids, lasers, interferon, and supportive wound care. Fortunately most hemangiomas resolve without complication, with or without treatment.
Let's move on to cherry angiomas. Unlike strawberry hemangiomas, these arise later in life, often after the age of 25-30 years. They are benign and asymptomatic. They appear as 2-5 mm pink to bright cherry red to purple smooth surfaced superficial bumps. They appear gradually over months to years. If many appear abruptly, they may be a sign of internal cancer. If an angioma grows in an area of skin subject to incidental trauma, then it may crust and bleed. In this instance, they can be treated. Also, some people request cosmetic removal. They can be easily treated with lasers or electrocautery.
In short, benign vascular lesions such as strawberries and cherries can appear at both spectrums of age. Don’t hesitate to contact us at Advanced Dermatology and any of our 13 dermatology experts would be happy to assist in diagnosis and management of these common growths.
by Andrea Dominey, MD
Board Certified Dermatologist
Advanced Dermatology & Skin Surgery