The "biker-glove" pattern of segmental infantile hemangiomas on the hands and feet

Abstract

Background: Infantile hemangiomas (IH) on the extremities have not been systematically studied.

Objective: We sought to describe the clinical characteristics and distribution patterns of IH affecting acral surfaces and to explore the relationship among these patterns, limb development, and IH pathogenesis.

Methods: This was a retrospective multicenter cohort study. Photographic archives from 4 tertiary pediatric dermatology referral centers were searched for patients with IH larger than 1 cm and involving 1 or more digit. Hemangioma location, distribution, and morphologic subtype were recorded. Medical records were reviewed for demographic and clinical data.

Results: In all, 73 patients were identified. The most common IH pattern resembled that of a "biker glove" (73%), followed by localized IH on the distal digits (14%), segmental IH extending over the distal digits (8%), and intermediate patterns (5%). Overall, 63% of acral IH were segmental, 26% indeterminate, and 11% localized. Five patients had associated structural anomalies. Complications were noted in 33% of cases.

Limitations: Limitations were retrospective study design; selection bias based on recall and photography; documentation and follow-up were not standardized across institutions; and treatment information may not reflect current approaches.

Conclusion: Acral IH display specific patterns and are associated with a relatively high risk of ulceration.

Keywords: acral; embryology; foot; hand; hemangioma; hypoxia; pathogenesis.