Characteristics and complications of anogenital infantile hemangiomas: A multicenter retrospective analysis

Abstract

Infantile hemangiomas (IHs) of the anogenital region remain poorly characterized. To examine the distribution, ulceration rate, and associated congenital anomalies of anogenital IHs. Retrospective study at 8 tertiary referral centers. A total of 435 infants with an IH of the anogenital region were enrolled (319 female, [73%]). Congenital anomalies were present in 6.4% (n=28) of infants with an anogenital IH. Segmental/partial segmental anogenital IHs ulcerated in 72% (n=99 of 138) of infants, while 45% (n=133 of 297) of focal anogenital IHs experienced ulceration (P= <.001). In a multivariable logistic regression analysis, segmental/partial segmental morphology (adjusted odds ratio [aOR] 2.70, 95% confidence interval [CI] 1.60-4.64), mixed type (aOR 3.44, 95% CI 2.01-6.07), perianal (aOR 3.01, 95% CI 1.53-6.12) and buttocks location (aOR 2.08, 95% CI 1.17-3.76), had an increased odds of ulceration. Segmental/partial segmental IHs of the genitalia were confined to distinct anatomic territories and were predominantly distributed unilaterally with a linear demarcation at the perineal raphe. Possible selection bias given recruitment at tertiary referral centers. This study improves our understanding of high-risk features of anogenital IHs and demonstrates that genital segmental/partial segmental IHs develop within distinct anatomic territories.