From the Guidelines
Widespread cherry hemangiomas typically do not require a medical workup as they are benign vascular lesions. These small, bright red papules commonly appear on the trunk and extremities, increasing in number with age. No specific diagnostic tests are needed for typical cherry hemangiomas as they can be diagnosed clinically based on their characteristic appearance. If the lesions have atypical features (rapid growth, bleeding, irregular borders, or unusual colors), a dermatology referral is appropriate for possible dermoscopy or biopsy to rule out other conditions. For cosmetic concerns, treatment options include electrocautery, laser therapy, shave excision, or cryotherapy, though these interventions are not medically necessary. According to the most recent guidelines, surgery and laser therapy may be recommended as treatment options in managing selected cases 1. However, decisions regarding their use should be made in consultation with a specialist, especially in young infants. Cherry hemangiomas develop due to localized proliferation of blood vessels in the skin and are associated with aging, pregnancy, and possibly environmental factors. They are completely benign and do not transform into malignancies, so routine monitoring is unnecessary unless changes occur in existing lesions.
Some key points to consider in the management of widespread cherry hemangiomas include:
- Clinical diagnosis is usually sufficient, and no specific diagnostic tests are needed for typical cases
- Atypical features may require further evaluation, such as dermoscopy or biopsy
- Cosmetic concerns can be addressed with various treatment options, including electrocautery, laser therapy, shave excision, or cryotherapy
- Surgery and laser therapy may be recommended in selected cases, but should be decided in consultation with a specialist 1
- Routine monitoring is not necessary unless changes occur in existing lesions.
It is essential to prioritize the patient's quality of life and consider the potential risks and benefits of any treatment options. In general, a conservative approach is recommended, and treatment should be individualized based on the patient's specific needs and circumstances.
From the Research
Workup of Widespread Cherry Hemangiomas
- The workup of widespread cherry hemangiomas may involve a combination of clinical evaluation, laboratory studies, and imaging tests 2.
- In some cases, cherry hemangiomas may be associated with underlying systemic diseases, such as multicentric Castleman disease (MCD), and a thorough workup is necessary to rule out these conditions 2.
- Optical coherence tomography (OCT) is a non-invasive imaging modality that can be used to evaluate the depth and extent of cherry hemangiomas, and may be useful in predicting response to laser therapy 3.
- Laboratory studies, such as complete blood count (CBC) and liver function tests (LFTs), may be ordered as part of the workup, but their utility in evaluating patients with cherry hemangiomas is not well established 4.
- Imaging tests, such as ultrasonography, computed tomography, and magnetic resonance imaging, may be used to evaluate the extent of cherry hemangiomas and rule out underlying systemic diseases 5.
Diagnostic Considerations
- The diagnosis of cherry hemangiomas is typically made based on clinical presentation and dermatoscopic examination 2.
- In some cases, a biopsy may be necessary to confirm the diagnosis and rule out other conditions 2, 5.
- The workup of widespread cherry hemangiomas should include a thorough evaluation for underlying systemic diseases, such as MCD, and a careful assessment of the patient's overall health status 2.