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“ Strawberry  Hemangioma Introduction Birthmark are colored skin spots that either are present at birth or develop shortly after birth. Birthmarks can be many different colors, including brown, tan, black, pale blue, pink, white, red, or purple. Some birthmarks are only colorations of the surface of the skin; others are raised above the surface of the skin or extend into the tissues under the skin.

The cause of most birthmarks is unknown. Most birthmarks are not inherited. Many folk tales and myths exist about the causes of birthmarks, but none of these stories have been proven to explain the true causes of birthmarks.

Most birthmarks need no treatment. They often fade as a child grows older. However, some birthmarks may need treatment because of their location. For example, a raised birthmark near a child's eye may interfere with his or her ability to see. In rare cases, birthmarks are associated with other conditions, such as growths on the liver, lungs, stomach, or intestines.

There are two main categories of birthmarks -- red birthmarks and pigmented birthmarks. Red birthmarks are colored, vascular (having to do with blood vessels) skin markings that develop before or shortly after birth. Pigmented birthmarks are skin markings that are present at birth.

The hemangioma is a common type of vascular birthmark. It is usually painless and harmless and its cause is not known. Color from the birthmark comes from the extensive development of blood vessels at the site.

Definition A hemangioma is a type of birthmark, characterized by a strawberry-like patch or nodule. While a hemangioma is a tumor, the tumor is noncancerous. Hemangiomas are comprised of what are known as endothelial cells. Your blood vessels are lined with endothelial cells. When you develop a hemangioma, these endothelial cells grow at a rapid rate. According to children’s Hospital Boston, a hemangioma is one of the most common "benign tumors in infants". A hemangioma is an abnormal buildup of blood vessels in the skin or internal organs. There are many types of hemangioma. Strawberry hemangioma is one of them. It gets its name from the fruit.

Alternative Names 	Strawberry mark, 	Nevus vascularis, 	Capillary hemangioma, 	Hemangioma simple, 	Juvenile hemangioma 	 Vascular skin changes 	Hemangioma simplex 	Angioma cavernosum

Symptoms   and   Locations A  hemangioma will appear as a flat birthmark that is red (or purple), soft, raised, squishy birthmarks with sharp borders. The birthmark can be located anywhere, but is most likely found upon your infant's face, head, chest or upper back. Strawberry hemangiomas occur in 1% to 3% of infants. As the hemangioma grows, the texture of the birthmark becomes spongy. The birthmark can grow in excess of two or three inches. As the birthmark eventually fades in size, your child may still have either a faint mark or extra skin that is left behind. Most children lose the appearance of their hemangiomas by the time they're 9 or 10. Most children with hemangiomas have only one. Many have a few. Rarely, children may have many, both on the skin and in the internal organs. These vary in size from a few millimeters across to many centimeters. There is a sharp line between the Strawberry hemangioma and normal skin. These usually resolve with time.

Most of them first show up within the first few days or weeks though it can be a few months and then progressively get a little larger for another few months. Typically by the time the baby reaches his or her first birthday the hemagioma will not get any larger and will actually start doing the reverse of fading away and shrinking.

So we can say: •	A red to reddish-purple, raised sore (lesion) on the skin •	A massive, raised tumor with blood vessel

Very important things is that It is not Contagious.

Causes Strawberry hemangiomas are found on at least one in fifty babies. They tend to run in families. Girls are more likely to have hemangiomas than boys. They are also more common in babies with lighter skin coloring. The Children’s Hospital of Boston estimates that between four and ten percent of light-skinned infants develop a strawberry hemangioma. They are found most prevalently on newborn girls, at a rate of three to five times higher than the rate at which males are affected. Often found on infants, a strawberry hemangioma is characterized by a collection of hardened blood vessels just below the surface of the skin. There is no definitive cause of strawberry hemangiomas on infants with no known controllable risk factors increasing an infant’s odds of developing one. Very rarely do African-American children develop hemangiomas. According to the Lucile Packard Children's Hospital at Standford, a hemangioma can also be an inherited trait. About 10 percent of children who develop a hemangioma have a family history of hemangiomas. Mutations of stem cells produced by the mother's placenta can also cause the development of hemangiomas.

Premature babies are more likely to have strawberry hemangiomas than babies born at term. Strawberry hemangiomas are usually not present at birth. Most appear between 3 and 5 weeks, and then grow quickly during the first six months. By the first birthday, most have already peaked in size. Many are gone by age two or three. Most are gone by school age. The great majority are gone without a trace before puberty. . In general, the size of the hemangioma and the location on the body does not correlate well with how completely it will disappear, although lip hemangiomas seem to be less likely to disappear completely. So we can say  : 1. The cause of Strawberry hemangioma is unknown. 2. These usually are not at birth time and develop on the skin after birth. Usually these are harmless and resolves easily. 3. The color results from the extensive development of blood vessels at the site. The more blood in vessels, redder is the skin. Normal skin goes pale when we are cold i.e. blood vessels constrict and goes bright red when we blush i.e. blood vessels dilate.

Signs  and   Tests S trawberry Hemangiomas are diagnosed by a physical examination. In the case of deep or mixed lesions, a CT or MRI scan may be performed. Sometimes blood tests or imaging studies are needed to assess the situation.

Occasionally, a strawberry hemangioma may occur with other rare conditions. Additional tests may be done for these syndromes.

Treatment For most infants, no treatment is necessary whatsoever. If the strawberry birthmark is in a place that it does not affect their normal development, the doctor will likely take a look at it when they have their periodic check-ups, but often will advise that no treatment is needed. There are a few cases however when a hemangioma must be treated, such as when it poses a threat to the baby growing and developing. For example, if the mark is extremely large in size it may be necessary to shrink it, especially if it is being scratched or risks becoming infected. Others that appear in places such as the ears, eyes, throat, or internally can be a cause for concern for both parents and doctors alike.

Fortunately, there are many different options available for treatment if it is believed to be necessary. Steroids, either taken orally or injected into the birthmark directly can often reduce the size and swelling without the need to surgically remove them. If this is unsuccessful, then laser surgery may be needed to remove or reduce the size of it. If your child needs treatment, speaking to your doctor will help you understand the best way to remove it as well as discuss the benefits and risks to the different ways to treat it.

Now we know that lasers have been used to reduce the size of the hemangiomas. Lasers that emit yellow light damage the vessels in the strawberry hemangioma without damaging the skin over it. Some physicians use a combination of steroid injection and laser therapy. Laser therapy or laser surgery can remove and stop the growth of a hemangioma. However, laser surgery can cause bleeding, infections, scarring, as well as permanent skin color changes. Corticosteroids are medications that can be injected, but can cause stunted growth, high blood sugar, and high blood pressure. It is important to discuss the potential risks and side effects that can be caused by treatments with your child's specialist before you consider treatments.

In short hand the treatments are: * Alpha Interferon: This therapy is limited to the most severe and potentially life threatening hemangiomas. It involves administering systemic medication via daily shots, usually into the leg, for several months. * If the Strawberry hemangioma is infected and open it may be treated with a short course of antibiotics and daily wound cleansing. * It's very important that a baby with a vascular birthmark be examined by a dermatologist as early as possible so that a correct diagnosis can be made and right treatment is given. * The most widely used treatment for rapidly growing hemangiomas is corticosteroid medication. This is either injected into the hemangioma or given by mouth. * Cryotherapy or Cryosurgery is a method of super-freezing tissue in order to destroy it. Liquid nitrogen is used to freeze the tissue and it destroys by itself. * Laser surgery uses a laser light source to remove diseased tissues or treat bleeding blood vessels. The laser may also be used for cosmetic purposes, including removal of wrinkles, tattoos, or birthmarks. Expectations (Prognosis) Small, superficial hemangiomas often disappear on their own. About 50% go away by age 5, and 90% are gone by age 9.

Complications 	B leeding (especially if the strawberry hemangioma is injured) 	Problems with breathing and eating 	Psychological problems, from skin appearance 	S econdary infections and sores 	V ision problems ( Amblyopia, strabismus) 	V isible changes in the skin

Calling Your Health Care Provider All birthmarks, including hemangiomas, should be evaluated by the health care provider during a routine examination. Hemangiomas of the eyelid may interfere with the development of normal vision and must be treated in the first few months of life. Hemangiomas that interfere with breathing, feeding, or other vital functions should also be treated early. Prevention There is no known way to prevent hemangiomas.