Atypical development and swift resolution of an ulcerated hemangioma: a case report
Abstract
Infantile hemangiomas are considered as the most common benign vascular tumors in pediatric patients. Ulceration is one of the most frequent complications that typically occur at 2–3 months after birth. A Caucasian Georgian male infant started to develop a hemangioma at 5 days old. At 3 weeks old, a pediatrician diagnosed it, and the patient was referred to a dermatologist. A week after starting initial treatment, at 4 weeks of age, the hemangioma ulcerated. Despite changing the initial treatment, the ulceration worsened. At 6 weeks old, topical timolol and mupirocin were initiated, leading to complete healing within 4 weeks. Timolol is still being applied, and follow-up visits showed no further ulceration. Although the exact cause of the unusual ulcer development is unknown, we advise physicians to avoid prescribing topical ointments that have not been proven effective and safe for treating hemangioma. Ulceration occurs in 16% of pediatric hemangioma cases, typically at 2–3 months after birth, and it is extremely rare in neonatal period; however, in this case, it occurred before 1 month of age. It is intriguing that it began to develop shortly after a physician prescribed topical solutions. We conducted an extensive literature search but could not find any articles implicating the ingredients in the prescribed topical solutions. Nevertheless, they should still be used with caution. This case shows a rapid resolution of an ulcerated anogenital hemangioma using timolol and…
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