{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T14:23:17Z","timestamp":1793024597201,"version":"4.5.0"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,3,1]]},"abstract":"<jats:p>OBJECTIVES. Large facial infantile hemangiomas have higher rates of complications than small localized hemangiomas, more often require treatment, and can be associated with neurological, ophthalmologic, and cardiac anomalies (PHACE syndrome). The anatomic patterns of these hemangiomas are often referred to as \u201csegmental\u201d despite a lack of precise anatomic definitions. Our study aims to define \u201csegmental\u201d hemangiomas based on clinically observed patterns. Our secondary goal is to relate the observed patterns to currently accepted developmental patterns to gain insight into hemangioma pathogenesis and craniofacial development.<\/jats:p>\n               <jats:p>METHODS. Photographic data were extracted from a large cohort of patients with infantile hemangiomas. We mapped 294 hemangiomas and recorded common morphologic patterns. Anatomic descriptions of the most common patterns were described and compared with accepted concepts of craniofacial development.<\/jats:p>\n               <jats:p>RESULTS. Four primary segments were identified (Seg1\u2013Seg4). Seg2 and Seg3 correspond with the previously recognized maxillary and mandibular prominences. Seg1 and Seg4 differ from standard human embryology texts. The frontotemporal segment, Seg1, encompasses the lateral forehead, anterior temporal scalp, and lateral frontal scalp. The segment Seg4, encompassing the medial frontal scalp, nasal bridge, nasal tip, ala, and philtrum, is substantially narrower on the forehead than the previously described frontonasal prominence.<\/jats:p>\n               <jats:p>CONCLUSIONS. The patterns provide new clues regarding facial development. The observed patterns resemble previously described facial developmental units on the lower face but are distinctly different on the upper face. The patterns suggest that neural crest derivatives may play a role in the development of facial hemangiomas. Finally, these patterns (Seg1\u2013Seg4) help standardize the nomenclature of facial segmental hemangiomas to analyze more effectively hemangioma risks and behavior.<\/jats:p>","DOI":"10.1542\/peds.2005-1092","type":"journal-article","created":{"date-parts":[[2006,3,1]],"date-time":"2006-03-01T19:23:43Z","timestamp":1141241023000},"page":"698-703","source":"Crossref","is-referenced-by-count":260,"title":["Patterns of Infantile Hemangiomas: New Clues to Hemangioma Pathogenesis and Embryonic Facial Development"],"prefix":"10.1542","volume":"117","author":[{"given":"Anita N.","family":"Haggstrom","sequence":"first","affiliation":[{"name":"Department of Dermatology, George Washington University, University Dermatology Associates, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Lammer","sequence":"additional","affiliation":[{"name":"Children's Hospital Oakland Research Institute, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Marcucio","sequence":"additional","affiliation":[{"name":"Dermatology and Pediatrics, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona J.","family":"Frieden","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, San Francisco General Hospital, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,3,1]]},"reference":[{"key":"2021120820140256100_R1","doi-asserted-by":"crossref","unstructured":"Chiller KG, Passaro D, Frieden IJ. Hemangiomas of infancy: clinical characteristics, morphologic subtypes, and their relationship to race, ethnicity, and sex. Arch Dermatol.\u20082002; 138: 1567\u20131576","DOI":"10.1001\/archderm.138.12.1567"},{"key":"2021120820140256100_R2","doi-asserted-by":"crossref","unstructured":"Waner M, North PE, Scherer KA, Frieden IJ, Waner A, Mihm MC Jr. The nonrandom distribution of facial hemangiomas. Arch Dermatol.\u20082003; 139: 869\u2013875","DOI":"10.1001\/archderm.139.7.869"},{"key":"2021120820140256100_R3","unstructured":"Larsen, WJ. Human Embryology. New York, NY: Churchill Livingstone; 1993:321;360\u2013371"},{"key":"2021120820140256100_R4","doi-asserted-by":"crossref","unstructured":"Happle R, Assim A. The lines of Blaschko on the head and neck. J Am Acad Dermatol.\u20082001; 44: 612\u2013615","DOI":"10.1067\/mjd.2001.112386"},{"key":"2021120820140256100_R5","unstructured":"Enjolras O, Riche MC, Merland JJ. Facial port-wine stains and Sturge-Weber syndrome. Pediatrics.\u20081985; 76: 48\u201351"},{"key":"2021120820140256100_R6","doi-asserted-by":"crossref","unstructured":"Wedden SE, Ralphs JR, Tickle C. Pattern formation in the facial primordia. Development.\u20081988; 103(suppl): 31\u201340","DOI":"10.1242\/dev.103.Supplement.31"},{"key":"2021120820140256100_R7","doi-asserted-by":"crossref","unstructured":"Francis-West P, Ladher R, Barlow A, Graveson A. Signalling interactions during facial development. Mech Dev.\u20081998; 75: 3\u201328","DOI":"10.1016\/S0925-4773(98)00082-3"},{"key":"2021120820140256100_R8","doi-asserted-by":"crossref","unstructured":"Schneider RA, Hu D, Helms JA. From head to toe: conservation of molecular signals regulating limb and craniofacial morphogenesis. Cell Tissue Res.\u20081999; 296: 103\u2013109","DOI":"10.1007\/s004410051271"},{"key":"2021120820140256100_R9","doi-asserted-by":"crossref","unstructured":"Couly G, Le Douarin NM. Head morphogenesis in embryonic avian chimeras: evidence for a segmental pattern in the ectoderm corresponding to the neuromeres. Development.\u20081990; 108: 543\u201358","DOI":"10.1242\/dev.108.4.543"},{"key":"2021120820140256100_R10","doi-asserted-by":"crossref","unstructured":"Hu D, Marcucio R, Helms JA. A zone of frontonasal ectoderm regulates patterning and growth in the face. Development.\u20082003; 130: 1749\u20131758","DOI":"10.1242\/dev.00397"},{"key":"2021120820140256100_R11","doi-asserted-by":"crossref","unstructured":"Noden DM. The control of avian cephalic neural crest cytodifferentiation. I. Skeletal and connective tissues. Dev Biol.\u20081978; 67: 296\u2013312","DOI":"10.1016\/0012-1606(78)90201-4"},{"key":"2021120820140256100_R12","doi-asserted-by":"crossref","unstructured":"Jiang X, Iseki S, Maxson RE, Sucov HM, Morriss-Kay GM. Tissue origins and interactions in the mammalian skull vault. Dev Biol.\u20082002; 241: 106\u2013116","DOI":"10.1006\/dbio.2001.0487"},{"key":"2021120820140256100_R13","doi-asserted-by":"crossref","unstructured":"Noden DM. Origins and patterning of avian outflow tract endocardium. Development.\u20081991; 111: 867\u2013876","DOI":"10.1242\/dev.111.4.867"},{"key":"2021120820140256100_R14","doi-asserted-by":"crossref","unstructured":"Noden DM. Origins and assembly of avian embryonic blood vessels. Ann N Y Acad Sci.\u20081990; 588: 236\u2013249","DOI":"10.1111\/j.1749-6632.1990.tb13214.x"},{"key":"2021120820140256100_R15","doi-asserted-by":"crossref","unstructured":"Korn J, Christ B, Kurz, H. Neuroectodermal origin of brain pericytes and vascular smooth muscle cells. J Comp Neurol.\u20082002; 442: 78\u201388","DOI":"10.1002\/cne.1423"},{"key":"2021120820140256100_R16","doi-asserted-by":"crossref","unstructured":"Allt G, Lawrenson JG. Pericytes: cell biology and pathology. Cells Tissues Organs.\u20082001; 169: 1\u201311","DOI":"10.1159\/000047855"},{"key":"2021120820140256100_R17","doi-asserted-by":"crossref","unstructured":"Metry DW, Dowd CF, Barkovich AJ, Frieden IJ. The many faces of PHACE syndrome [published correction appears in J Pediatr. 2001;139:470]. J Pediatr.\u20082001; 139: 117\u2013123.","DOI":"10.1067\/mpd.2001.114880"},{"key":"2021120820140256100_R18","unstructured":"North PE, Waner M, Mizeracki A, et al. A unique microvascular phenotype shared by juvenile hemangiomas and human placenta. Arch Dermatol.\u20082001; 137: 559\u2013570"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/117\/3\/698\/1071374\/zpe00306000698.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/117\/3\/698\/1071374\/zpe00306000698.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T23:53:18Z","timestamp":1639007598000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/117\/3\/698\/68640\/Patterns-of-Infantile-Hemangiomas-New-Clues-to"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,3,1]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2006,3,1]]},"published-print":{"date-parts":[[2006,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2005-1092","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,3,1]]}}}