Treatment of Infantile Hemangiomas With Beta-Blockers

A Review

Sonal Shah, MD; Ilona J. Frieden, MD


Skin Therapy Letter. 2013;18(6) 

In This Article

Pathogenesis of Infantile Hemangiomas

IH are neoplasms of benign endothelial cells. For decades it was assumed that these vascular tumors were manifestations of angiogenesis, i.e., the sprouting of new blood vessels from pre-existing ones. However, recent emerging evidence indicates that they may develop via vasculogenesis, the de novo formation of blood vessels from progenitor cells.[11,12] Local or systemic hypoxemia may be a common denominator in hemangioma growth. Both placental and perinatal abnormalities may be potentiating factors that induce increased blood vessel formation and, thus, contribute to the development of IH.[12–14]

In recent years, several review articles have summarized many of the advances in understanding the pathogenesis of IH.[11,15–17] Vascular endothelial growth factor (VEGF) regulation appears to play a central role in the proliferation of hemangiomas. Another remarkable insight is the recognition that endothelial cell precursor cells of IH represent a fetal, rather than postnatal phenotype, with the capability of transforming to adipocytes. Although much more work is needed, uncovering the pathogenesis of IH has occurred at a far greater pace in the past decade and a half than in prior history.