A retrospective multicenter cohort study of differences in clinical characteristics of Infantile Hemangiomas in preterm and term infants: Prematurity increases risk of permanent cutaneous sequelae.

Background: We observed many preterm infants with unexpectedly thick infantile hemangiomas (IH), a subtype known to be associated with an increased risk of scarring.

Objective: To cf the clinical features of localized IH in preterm vs term infants.

Methods: A retrospective study was conducted at 3 tertiary referral centers involving 830 consecutive patients with localized IH.

Results: Preterm infants had a significantly higher incidence of superficial IH (75% in <33 weeks, 57% in 33 to <37 weeks, and 50% in term infants, P = .007). Overall, their IH had thicker superficial components (P < .001) and more stepped borders (P < .001). These features correlated with the degree of prematurity. The average chronological age at presentation to the specialist was 5.6 (SD = 6.2) months, with no difference observed in gestational age.

Limitations: The retrospective design and use of nonstandardized clinical photographs. There may be biases introduced toward more severe IH types because the study sites were tertiary referral centers.

Conclusions: Preterm infants have features of IH that have obvious implications for systemic therapies. Most of these infants were seen beyond the typical proliferative phase when irreversible skin changes may have already occurred.