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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Congenital hemangioma &#40;CH&#41; is a type of vascular tumor that develops in the uterus and is therefore fully formed at birth&#46; CH differs from infantile hemangioma &#40;IH&#41; both clinically and histologically&#46; Immunohistochemistry for the marker Glut-1 &#40;glucose transporter-1&#41; is characteristically positive in IH and negative in CH&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">CH can be divided into three subgroups based on tumor course&#58; rapidly involuting CH &#40;RICH&#41;&#59; non-involuting CH &#40;NICH&#41;&#59; and partially involutional CH &#40;PICH&#41;&#46; RICH is characterized by regression between 6 and 14 months&#44; sometimes without leaving a residual lesion&#44; and in other cases leaving progressive underlying lipoatrophy after rapid involution&#46; NICH does not involute&#46; PICH initially behaves like RICH but involution stops at a certain point&#44; leaving a lesion indistinguishable from NICH&#46; There is marked clinical overlap between the different forms of CH&#46; PICH was described later than RICH and NICH&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and therefore it is highly likely that some cases of NICH described in the literature actually correspond to PICH&#46; Distinction between PICH and NICH is difficult in the absence of images acquired during the first days of life&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">NICH is slightly more common in girls and more frequently appears on the trunk and extremities&#46; This is a vascular-like lesion of which two clinical variants have been described&#58; a macule with a slightly atrophic surface that may exhibit mild induration or turgor on palpation&#59; and a nodular or plaque-like lesion&#46; In both cases a slight increase in temperature can be perceived upon palpation and Doppler ultrasound reveals an increase in flow&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Two recent publications described possible atypical postnatal growth of NICH&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> Until recently there were only isolated reports of this type of hemangioma&#46; However&#44; Cossio et al<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> reported a series of 80 NICH&#44; of which 9 &#40;11&#46;2&#37;&#41; exhibited growth after a period of stability of 2&#8211;10 years &#40;mean&#44; 5&#46;3 years&#41;&#46; Furthermore&#44; the authors reported the appearance of telangiectasias&#44; reddish&#44; occasionally bleeding papules&#44; and pyogenic granulomas on these tumors&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It has been suggested that persistent high flows in the vessels of these lesions may account for late growth&#44; and that this could be much more frequent than reported&#44; since in many cases CH is operated on before adolescence&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> In both NICH and RICH somatic mutations have been described in codon 209 &#40;Gln209&#41; in GNAQ and GNA11&#44; suggesting that their course is determined by other genetic&#44; epigenetic&#44; or environmental factors&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; CH is a group of rare vascular tumors that share a series of genetic and clinical characteristics but differ in their course&#44; which is influenced by factors that remain to be identified&#46;</p></span>"
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Resident’s Forum
Noninvoluting Congenital Hemangiomas That Exhibit Postnatal Growth
Hemangiomas congénitos no involutivos (NICH) con crecimiento postnatal
J. Boix-Vilanova
Corresponding author
julian.boix@gmail.com

Corresponding author.
, I. Gracia-Darder, A. Martín-Santiago
Servicio de Dermatología del Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Congenital hemangioma &#40;CH&#41; is a type of vascular tumor that develops in the uterus and is therefore fully formed at birth&#46; CH differs from infantile hemangioma &#40;IH&#41; both clinically and histologically&#46; Immunohistochemistry for the marker Glut-1 &#40;glucose transporter-1&#41; is characteristically positive in IH and negative in CH&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">CH can be divided into three subgroups based on tumor course&#58; rapidly involuting CH &#40;RICH&#41;&#59; non-involuting CH &#40;NICH&#41;&#59; and partially involutional CH &#40;PICH&#41;&#46; RICH is characterized by regression between 6 and 14 months&#44; sometimes without leaving a residual lesion&#44; and in other cases leaving progressive underlying lipoatrophy after rapid involution&#46; NICH does not involute&#46; PICH initially behaves like RICH but involution stops at a certain point&#44; leaving a lesion indistinguishable from NICH&#46; There is marked clinical overlap between the different forms of CH&#46; PICH was described later than RICH and NICH&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and therefore it is highly likely that some cases of NICH described in the literature actually correspond to PICH&#46; Distinction between PICH and NICH is difficult in the absence of images acquired during the first days of life&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">NICH is slightly more common in girls and more frequently appears on the trunk and extremities&#46; This is a vascular-like lesion of which two clinical variants have been described&#58; a macule with a slightly atrophic surface that may exhibit mild induration or turgor on palpation&#59; and a nodular or plaque-like lesion&#46; In both cases a slight increase in temperature can be perceived upon palpation and Doppler ultrasound reveals an increase in flow&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Two recent publications described possible atypical postnatal growth of NICH&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> Until recently there were only isolated reports of this type of hemangioma&#46; However&#44; Cossio et al<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> reported a series of 80 NICH&#44; of which 9 &#40;11&#46;2&#37;&#41; exhibited growth after a period of stability of 2&#8211;10 years &#40;mean&#44; 5&#46;3 years&#41;&#46; Furthermore&#44; the authors reported the appearance of telangiectasias&#44; reddish&#44; occasionally bleeding papules&#44; and pyogenic granulomas on these tumors&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It has been suggested that persistent high flows in the vessels of these lesions may account for late growth&#44; and that this could be much more frequent than reported&#44; since in many cases CH is operated on before adolescence&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> In both NICH and RICH somatic mutations have been described in codon 209 &#40;Gln209&#41; in GNAQ and GNA11&#44; suggesting that their course is determined by other genetic&#44; epigenetic&#44; or environmental factors&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; CH is a group of rare vascular tumors that share a series of genetic and clinical characteristics but differ in their course&#44; which is influenced by factors that remain to be identified&#46;</p></span>"
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Article information
ISSN: 15782190
Original language: English
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