Infantile hemangiomas: from clinical aspects to evolution of pathogenesis understanding and improvement of therapeutic strategies
DOI: 10.32364/2618-8430-2026-9-*-0
Infantile hemangiomas: from clinical aspects to evolution of pathogenesis understanding and improvement of therapeutic strategies
G.V. Kondratiev1, M.E. Melnikov1, Yu.M. Spivakovskiy2
1 Saint Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation
2 V.I. Razumovskiy Saratov State Medical University, Saratov, Russian Federation
Infantile hemangiomas (IH) are the most common benign vascular infantile tumors characterized by variable clinical manifestations and specific natural course patterns which determine an individualized approach to patient management. The paper systematizes and updates data on biological and clinical features of IH. Also, it considers promising therapeutic directions. Special attention is paid to propranolol, a non-selective β-blocker that has become an important tool in systemic therapy of IH, as well as to the analysis of its therapeutic efficacy and practical aspects of the oral solution use. The presented clinical examples highlight a scope of systemic propranolol therapy for IH and demonstrate the importance of timely diagnosis, as well as assessment of indications for the therapy, and an individualized approach to treatment. Modern data generalization provide systematization of knowledge about clinical features, pathogenetic mechanisms, and therapeutic strategies in patients with IH.
Keywords: infantile hemangioma, vascular tumors, β-blockers, propranolol, hemangiol, children, life-threatening conditions.
For citation: Kondratiev G.V., Melnikov M.E., Spivakovskiy Yu.M. Infantile hemangiomas: from clinical aspects to evolution of pathogenesis understanding and improvement of therapeutic strategies. Russian Journal of Woman and Child Health. 2026;9(4):–12 (in Russ.). DOI: 10.32364/2618-8430-2026-9-*-
About the authors:
Gleb V. Kondratiev — Pediatric Oncologist, Assistant, Head of the Teaching Department, Department of Oncology, Pediatric Oncology and Radiation Therapy, Saint Petersburg State Pediatric Medical University; 2, Litovskaya str., St. Petersburg, 194100, Russian Federation; ORCID iD 0000-0002-1462-6907
Maksim E. Melnikov — Pediatric Oncologist, Teaching Assistant of the Department of Oncology, Pediatric Oncology and Radiation Therapy, Saint Petersburg State Pediatric Medical University; 2, Litovskaya str., St. Petersburg, 194100, Russian Federation; ORCID iD 0000-0003-4744-0882
Yurii M. Spivakovskiy — C. Sc. (Med.), Assistant Professor, Head of the Department of Faculty Pediatrics, Director of the University Clinic of Faculty Pediatrics, V.I. Razumovskiy Saratov State Medical University; 112, Bolshaya Kazach'ya str., Saratov, 410012, Russian Federation; ORCID iD 0000-0002-3077-570X
Contact information: Gleb V. Kondratiev, e-mail: spbgvk@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 20.08.2026.
Revised 14.09.2026.
Accepted 07.10.2026.
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3. Rešić A., Barčot Z., Habek D. et al. The Evaluation, Diagnosis, and Management of Infantile Hemangiomas — A Comprehensive Review. J Clin Med. 2025;14(2):425. DOI: 10.3390/jcm14020425
4. Хачатрян Л.А., Клецкая И.С. Просто о сложном: инфантильная гемангиома. Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2021;20(1):192–206. DOI: 10.24287/1726-1708-2021-20-1-192-206. Khachatryan L.A., Kletskaya I.S. Simple about complex: infantile hemangioma. Pediatric Hematology/Oncology and Immunopathology. 2021;20(1):192–206 (in Russ.). DOI: 10.24287/1726-1708-2021-20-1-192-206
5. Kunimoto K., Yamamoto Y., Jinnin M. ISSVA Classification of Vascular Anomalies and Molecular Biology. Int J Mol Sci. 2022;23(4):2358. DOI: 10.3390/ijms23042358
6. Mulliken J.B., Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;69(3):412–422. DOI: 10.1097/00006534-198203000-00002
7. Jangid S.D., Madke B., Bhatt D., Singh A.L. A Systematic Review on Management of Infantile Hemangiomas: How Far We Have Reached in this Past Decade. Indian Journal of Paediatric Dermatology. 2024;25(3):188–194. DOI: 10.4103/ijpd.ijpd_65_24
8. Neri I., Orioni G., Leuzzi M. et al. Infantile Hemangioma with Minimal or Arrested Growth (IHMAG): A Retrospective Analysis of Clinical and Dermoscopic Diagnostic Clues. Dermatol Pract Concept. 2024;14(3):e2024206. DOI: 10.5826/dpc.1403a206
9. Holm A., Mulliken J.B., Bischoff J. Infantile hemangioma: the common and enigmatic vascular tumor. J Clin Invest. 2024;134(8):e172836. DOI: 10.1172/JCI172836
10. Qiu T., Yang K., Dai S. et al. Clinical Features of Segmental Infantile Hemangioma: A Prospective Study. Ther Clin Risk Manag. 2021;17:119–125. DOI: 10.2147/TCRM.S291059
11. Davenport R., Su J.C., Nathalie J. et al. Clinical overlap of PHACE and LUMBAR syndromes. Pediatr Dermatol. 2022;39(5):752–756. DOI: 10.1111/pde.15031
12. Fernández Faith E., Shah S.D., Braun M. et al. Incidence and clinical factors associated with ulceration in infantile hemangiomas. J Am Acad Dermatol. 2023;88(2):414–420. DOI: 10.1016/j.jaad.2022.10.047
13. Cheng C.E., Friedlander S.F. Infantile hemangiomas, complications and treatments. Semin Cutan Med Surg. 2016;35(3):108–116. DOI: 10.12788/j.sder.2016.050
14. Туркия Л.Р., Муфтахова Г.М., Карманова Д.А. и др. Инфантильная гемангиома и диффузный гемангиоматоз печени у новорожденных с развитием жизнеугрожающих состояний. РМЖ. Мать и дитя. 2025;8(2):173–182. DOI: 10.32364/2618-8430-2025-8-2-10. Turkiya L.R., Muftakhova G.M., Karmanova D.A. et al. Infantile hemangioma and diffuse hepatic hemangiomatosis in newborns with the development of life-threatening conditions. Russian Journal of Woman and Child Health. 2025;8(2):173–182 (in Russ.). DOI: 10.32364/2618-8430-2025-8-2-10
15. Corbeddu M., Meucci D., Diociaiuti A. et al. Management of Upper Airway Infantile Hemangiomas: Experience of One Italian Multidisciplinary Center. Front Pediatr. 2021;9:717232. DOI: 10.3389/fped.2021.717232
16. MacDougall M.S., Afzal S.Y., Freedman M.S. et al. Infant in extremis: respiratory failure secondary to lower airway infantile hemangioma. BMC Pediatr. 2022;22(1):744. DOI: 10.1186/s12887-022-03821-1
17. Zhao J., Huang A.R., Rainer B.M. et al. Periocular infantile hemangiomas: Characteristics, ocular sequelae, and outcomes. Pediatr Dermatol. 2019;36(6):830–834. DOI: 10.1111/pde.13925
18. Sun L., Li Y., Lin X. et al. Periorbital infantile hemangiomas complicated with strabismus. Chin J Plast Reconstr Surg. 2025. DOI: 10.1016/j.cjprs.2025.09.002
19. Tavakoli M., Yadegari S., Mosallaei M. et al. Infantile Periocular Hemangioma. J Ophthalmic Vis Res. 2017;12(2):205–211. DOI: 10.4103/jovr.jovr_66_17
20. Fath L., Simon F., Levy R. et al. Dangers and therapeutic difficulties of intracranial hemangioma in infants: A CARE case report. Eur Ann Otorhinolaryngol Head Neck Dis. 2024;141(4):227–230. DOI: 10.1016/j.anorl.2024.02.001
21. Duffy K.J., Runge-Samuelson C., Bayer M.L. et al. Association of hearing loss with PHACE syndrome. Arch Dermatol. 2010;146(12):1391–1396. DOI: 10.1001/archdermatol.2010.201
22. Braun V., Prey S., Gurioli C. et al. Congenital haemangiomas: a single-centre retrospective review. BMJ Paediatr Open. 2020;4(1):e000816. DOI: 10.1136/bmjpo-2020-000816
23. Хачатрян Л.А., Чиквина И.И., Клецкая И.С. В поисках редкой болезни: врожденные гемангиомы. Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2021;20(1):145–155. DOI: 10.24287/1726-1708-2021-20-1-145-155. Khachatryan L.A., Chikvina I.I., Kletskaya I.S. In search of a rare disease: congenital hemangiomas. Pediatric Hematology/Oncology and Immunopathology. 2021;20(1):145–155 (in Russ.). DOI: 10.24287/1726-1708-2021-20-1-145-155]
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