From the Guidelines
Multiple cherry hemangiomas are generally benign and do not typically indicate a significant medical concern, but having five or more cutaneous hemangiomas may be associated with a higher risk of liver hemangiomas and other complications, as noted in the clinical practice guideline for the management of infantile hemangiomas 1.
Key Points to Consider
- Multiple cherry hemangiomas are common, especially in adults over 30, and tend to increase in number with age.
- A sudden appearance of many new lesions should prompt a medical evaluation, as this could rarely be associated with certain medical conditions like pregnancy, liver damage, or exposure to certain chemicals.
- No treatment is necessary for cherry hemangiomas unless they bleed, cause discomfort, or create cosmetic concerns.
- If removal is desired, options include laser therapy, electrocautery, cryotherapy, or shave excision, all of which are typically performed in a dermatologist's office.
Important Considerations for High-Risk Hemangiomas
- Having five or more cutaneous hemangiomas may be associated with a higher risk of liver hemangiomas and other complications, such as cardiac failure and hypothyroidism, as noted in the clinical practice guideline for the management of infantile hemangiomas 1.
- The clinical practice guideline for the management of infantile hemangiomas emphasizes the importance of early intervention and/or referral for infants who have potentially problematic hemangiomas, including those with five or more cutaneous hemangiomas 1.
Recommendations for Management
- Regular skin checks are recommended to monitor any changes in existing hemangiomas or the appearance of new ones.
- If a patient has five or more cutaneous hemangiomas, screening ultrasonography may be recommended to evaluate for liver hemangiomas, as noted in the clinical practice guideline for the management of infantile hemangiomas 1.
From the Research
Multiple Cherry Hemangiomas Significance
- Multiple cherry hemangiomas can be a sign of an underlying condition, such as multicentric Castleman disease (MCD) 2.
- The sudden onset of multiple cherry hemangiomas can be a heralding sign of MCD and other lymphoproliferative diseases 2.
- In some cases, multiple hemangiomas can be associated with the presence of hemangiomas in inner organs, such as the liver or mesenteric lesions 3.
- Preterm infants and patients with high numbers of cutaneous hemangiomas are at higher risk of organ involvement 3.
- The presence of multiple cherry hemangiomas can be a diagnostic clue for underlying conditions, and careful evaluation and follow-up are necessary to rule out potential complications 2.
Treatment and Outcome
- Various treatment modalities exist for cherry angiomas, including laser therapy, cryotherapy, sclerotherapy, and electrosurgery 4.
- Pulsed dye laser (PDL) therapy is a common treatment for cherry angiomas, but it can be associated with complications, such as pyogenic granuloma 5.
- The outcome of multiple cherry hemangiomas can vary, and in some cases, life-threatening events can occur, especially in preterm infants or patients with high numbers of cutaneous hemangiomas 3.
- Cosmetic outcome can be a relevant factor in the treatment of cherry angiomas, and PDL therapy can be considered as an alternative treatment up to the age of 6 months 6.