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These
hemangiomas commonly ulcerate. Frequent diaper
change is important in these patients. Laser
treatment should be considered especially if the
hemangioma ulcerates which is unresponsive to
appropriate wound care. Systemic steroids should
also be considered in some patients.
Wound
Care: Thin hydrocolloid wound or zinc paste
dressing replaced every 3 days is advisable to
minimize the pain and lessen the urine and stool
contamination. If the ulceration enlarges and/or
becomes infected, systemic antibiotics
(erythromycin) should be considered. Some physicians
recommend open wet povidone iodine or saline
compresses, very gentle cleansing with povidone
iodine, 10% solution, for 5 to 10 minutes and
application of topical bacitracine or mupirocin
ointment four times daily. For extensive infections,
a systemic antistaphylococcal antibiotic for 14 to
21 days is recommended. Also, leaving the diaper off
for an hour or so after each change is recommended.
For protecting the ulcerated area, occlusive
dressings (e.g. Duoderm pads) can be used.
References:
Moroz B. Pediatric Dermatology 1997;14:57-83
/ A.M. Margileth. Pediatric Dermatology
1997;14:57-83
/ Goldberg GN. Pediatric Dermatology 1997;14:57-83
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