Document Detail

Bleeding in Congenital Hemangiomas: Crusting as a Clinical Predictive Sign and Usefulness of Tranexamic Acid.
MedLine Citation:
PMID:  21995591     Owner:  NLM     Status:  Publisher    
  We present two case reports of CH in which severe bleeding episodes occurred during the first weeks of life and report the use of topical tranexamic acid to control bleeding in this setting. Patient 1 was a full-term female infant who presented at birth with a large 7- by 6-cm CH of the forehead showing a few millimeter-sized crusts. No active treatment except close follow-up was advised. At 10 weeks of age, the size of the lesion having spontaneously decreased more than 50%, she presented with severe bleeding from a small crusted area. The bleeding was controlled using topical tranexamic acid, and except for a few minor, easily controlled bleeding episodes in the following weeks, the lesion regressed more than 80%. Patient 2 was a full-term male infant seen at 1 day of life for a 14- by 10-cm CH of the right knee with a few small, dark, superficial crusts. At 3 weeks of age, he was hospitalized after severe bleeding from one of the crusted areas, with a drop in hemoglobin from 131 to 114 g/L. Bleeding was controlled using topical tranexamic acid, and compressive dressing. Because the lesion was clinically a rapidly involuting CH, there was no need for embolization or surgery. The presence of crusting in CH, even in the absence of frank ulceration, is an ominous sign and can precede serious bleeding. Tranexamic acid, an antifibrinolytic agent that helps stabilize the clot, has proved useful topically in controlling bleeding in CH.
Julie Powell; Marie-Michèle Blouin; Michèle David; Josée Dubois
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-13
Journal Detail:
Title:  Pediatric dermatology     Volume:  -     ISSN:  1525-1470     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8406799     Medline TA:  Pediatr Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Division of Pediatric Dermatology, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Quebec Canada Division of Dermatology, Centre Hospitalier Universitaire de Quebec, Laval University, Quebec City, Montreal, Canada Division of Pediatric Hematology-Oncology, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada Department of Medical Imaging, CHU Sainte-Justine, University of Montreal, Montreal, Quebec Canada.
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