Histopathology of capillary hemangiomas treated with pulsed–dye laser and intralesional steroids

Abstract

Abstract: : Purpose: To report the histopathological findings of excised periorbital capillary hemangiomas previously treated with pulsed–dye laser and intralesional steroids. Methods: Three consecutive patients from 1996–2003 that underwent excision of capillary hemangiomas previously treated with pulsed–dye laser ablation were included. One patient was also initially treated with intralesional steroids due to induced astigmatism. One patient received an intralesional steroid injection at 3 months of age. Excised specimens were fixed immediately in formalin, followed by routine examination with hematoxylin and eosin stain. Results: In all cases, there was histologic evidence of capillary sclerosis and abundant collagen deposition. Fatty infiltration, a finding characteristic of mature capillary hemangiomas, was only seen in one case. In two of the patients, we were able to detect abnormalities within orbicularis myofibers, characterized by enlargement of some muscle fibers, loss of normal skeletal muscle striations and presence of regenerating fibers. We also observed mild glandular hypertrophy in two patients and mild sebaceous hypertrophy in one patient. There did not appear to be any histological differences between cases treated with or without steroids. Conclusions: Predominant histological findings in capillary hemangiomas previously treated with pulsed–dye laser are: 1) capillary sclerosis, 2) collagen deposition, 3) myopathic changes in orbicularis fibers, and 4) glandular hypertrophy. There were no findings that appeared to be a result of intralesional steroid treatment.

Keywords: laser • tumors • eyelid