Hemangioma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Surgery

• Surgical management involves excision, laser treatment or both.
• Intralesional steroid treatment is also an option for focal hemangiomas such as:

• Parotid
• Nasal tip
• Subglottis
• Eyelid

• Repeat therapy is often required, but systemic side effects are limited.
• Excision is the appropriate for localized lesions the fibrofatty remnants (residuum) of involuted hemangiomas.
• Elective subtotal excision of massive protuberant proliferating hemangiomas can be employed in order to maintain aesthetic facial boundaries.
• Small remnants of disease are then left for involution.
• Residual erythema and telangiectasias frequently remain in involuted hemangiomas and are best treated by selective photothermolysis using the flash pulse dye laser (FPDL). *Similarly, ulcerative lesions during proliferation can be treated with FPDL to induce healing and new epidermal growth.

Excision

• Excision is the appropriate for localized lesions the fibrofatty remnants (residuum) of involuted hemangiomas.
• Elective subtotal excision of massive protuberant proliferating hemangiomas can be employed in order to maintain aesthetic facial boundaries.
• Small remnants of disease are then left for involution.

Pulsed dye laser

Pulsed dye laser is considered to be effective choice for a series of skin disorders including superficial hemangiomas.

• Residual erythema and telangiectasias frequently remain in involuted hemangiomas and are best treated by selective photothermolysis using the flash pulse dye laser (FPDL). *Ulcerative lesions during proliferation can be treated with FPDL to induce healing and new epidermal growth.