1. Drolet BA, Frommelt PC, Chamlin SL, Haggstrom A, Bauman NM, Chiu YE, Chun RH, Garzon MC, Holland KE, Liberman L, Maclellan-Tobert S, Mancini AJ, Metry D, Puttgen KB, Seefeldt M, Sidbury R, Ward KM, Blei F, Baselga E, Cassidy L, Darrow DH, Joachim S, Kwon EK, Martin K, Perkins J, Siegel DH, Boucek RJ, Frieden IJ. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics. 2013;131(1):128-40.
- Despite the relative frequency of Infantile Hemangioma (IH) and the potential for severe complications, there are currently no standardized guidelines for treatment. Although the use of propranolol has rapidly been adopted, there is significant uncertainty and differences of opinion regarding safety monitoring, dose escalation, and its use in PHACE syndrome. A consensus conference was held, at which time a multidisciplinary team reviewed existing data on propranolol and all published reports pertaining to the use of propranolol in pediatric patients. Because of the absence of high-quality clinical research data, evidence-based recommendations are not possible at this time. However, the team agreed on a number of recommendations based on existing evidence, including when to treat complicated IH; contraindications and pretreatment evaluation protocols; propranolol use in PHACE syndrome; formulation, target dose, and frequency of propranolol; initiation of propranolol in infants; cardiovascular monitoring; ongoing monitoring; and prevention of hypoglycemia. We acknowledge that the recommendations are conservative in nature but we anticipate that they will be revised as more data becomes available.
2. Siegel DH, Shieh JT, Kwon EK, Baselga E, Blei F, Cordisco M, Dobyns WB, Duffy KJ, Garzon MC, Gibbs DL,Grimmer JF, Hayflick SJ, Krol AL, Kwok PY, Lorier R, Matter A, McWeeney S, Metry D, Mitchell S, Pope E, Santoro JL, Stevenson DA, Bayrak-Toydemir P, Wilmot B, Worthey EA, Frieden IJ, Drolet BA, Broeckel U. Copy Number Variation Analysis in 98 Individuals with PHACE Syndrome. J Invest Dermatol. 2013; 133(3):677-84.
- PHACE syndrome is the association of large segmental facial hemangiomas and congenital anomalies, such as posterior fossa malformations, cerebral arterial anomalies, coarctation of the aorta, eye anomalies, and sternal defects. To date, the reported cases of PHACE syndrome have been sporadic, suggesting that PHACE may have a complex pathogenesis. We report here genomic copy number variation (CNV) analysis of 98 individuals with PHACE syndrome as a first step in deciphering a potential genetic basis of PHACE syndrome. A total of 3,772 CNVs (2,507 duplications and 1,265 deletions) were detected in 98 individuals with PHACE syndrome. CNVs were then eliminated if they failed to meet established criteria for quality, spanned centromeres, or did not contain genes. CNVs were defined as "rare" if not documented in the database of genomic variants. Ten rare CNVs were discovered, however, there were no rare CNV events that occurred in more than one subject. Therefore, further study is needed to determine the significance of these CNVs in the pathogenesis of PHACE syndrome.
3. Siegel DH, Tefft KA, Kelly T, Johnson C, Metry D, Burrows P, Pope E, Cordisco M, Holland KE, Maheshwari M, Keith P, Garzon M, Hess C, Frieden IJ, Fullerton HJ, Drolet BA. Stroke in Children With Posterior Fossa Brain Malformations, Hemangiomas, Arterial Anomalies, Coarctation of the Aorta and Cardiac Defects, and Eye Abnormalities (PHACE) Syndrome: A Systematic Review of the Literature. Stroke. 2012; 43(6): 1672-4.
- Several case reports of arterial ischemic stroke (AIS) in individuals with PHACE syndrome have been published, but risk factors for AIS in PHACE have not been clearly defined. The objective of this article is to review all cases of stroke in PHACE in children and describe clinical characteristics that may be associated with an increased risk of AIS. Examination of our PHACE population revealed, 22 individuals with PHACE and AIS were identified. Imaging of the arteries of the head and neck was reported in 20 of 22. Narrowing or nonvisualization of at least one great cerebral vessel was present in 19 of 20 and of those, 15 had greater than or equal to two vessels involved. Aortic arch anomalies were reported in 13 of 22 individuals. In conclusion, aplasia, hypoplasia, or occlusion of a major cerebral artery appears to be a significant risk factor for AIS in children with PHACE, especially when more than one vessel is involved or if there is coarctation of the aorta.
4. Drolet BA, Pope E, Juern AM, Sato T, Howell B, Puttgen KB, Lara-Corrales I, Gilliam A, Mancini A, Powell J, Siegel D, Metry D, Stevenson DA, Grimmer JF, Frieden IJ. Gastrointestinal Bleeding in Infantile Hemangioma: A Complication of Segmental, Rather than Multifocal, Infantile Hemangiomas. J Pediatr. 2012; 160(6):1021-6 e3.
- The goal of this study was to highlight an association of facial segmental hemangiomas with gastrointestinal bleeding in infants with infantile hemangiomas. We conducted a muticenter review of PHACE patients. The study found that gastrointestinal bleeding is a rare complication of true infantile hemangioma. The segmental pattern of the cutaneous hemangioma associated with gastrointestinal bleeding should suggest a segmental infantile hemangioma of the lower gastrointestinal tract.
5. Chiu YE, Drolet BA, Blei F, Carcao M, Fangusaro J, Kelly ME, Krol A, Lofgren S, Mancini AJ, Metry DW, Recht M, Silverman RA, Tom WL, Pope E. Variable response to propranolol treatment of kaposiform hemangioendothelioma, tufted angioma, and Kasabach-Merritt phenomenon. Pediatr Blood Cancer. 2012; 59(5):934-8.
- Propranolol is a non-selective beta-adrenergic antagonist successfully used in a case of kaposiform hemangioendothelioma (KHE) associated with Kasabach-Merritt phenomenon (KMP). We report 11 patients treated with propranolol for KHE and the related variant tufted angioma (TA), six of whom also had KMP. The varied responses to treatment, with only 36% responding in our series, demonstrate the need for further study of this medication before routine use for these indications.
6. Iacobas I, Burrows PE, Adams DM, Sutton VR, Hollier LH, Chintagumpala MM . Oral rapamycin in the treatment of patients with hamartoma syndromes and PTEN mutation. Pediatr Blood Cancer 2011 Aug;57(2):321-3.
- Bannayan-Riley-Ruvacalba syndrome (BRRS) belongs to the PTEN hamartoma tumor syndromes and is characterized by a high risk of malignancy in early adulthood added to local destructive effects of hamartomas in childhood. There is no standard treatment for this condition and patients are usually offered symptomatic surgical relief. Rapamycin has been reported to be effective in the management of other conditions associated with PTEN mutation. We report here a case of BRRS in a 6-year-old male with progressive loss of function of left hand and forearm associated with pain. He was treated with oral rapamycin and regained pain-free full mobility.
7. Noel RJ, Duffy KJ, Kelly ME, Tondravi N, North PE, Drolet BA. Endoscopic Management Of Gastrointestinal Bleeding From Multifocal Lymphangioendotheliomatosis With Thrombocytopenia (MLT): Limited Efficacy And Complications. J Pediatr Gastroenterol Nutr. 2011; 54(6):822-4.
- Clinical data in our clinical registry for patients with vascular anomalies and associated coagulopathies include the use of argon plasma coagulation (APC) in 4 infants with GI bleeding and MLT. The limited data regarding endoscopic management of GI bleeding from MLT suggest that endoscopic APC is ineffective in the ultimate management of GI bleeding and constitutes a potential source for complications. Although APC can achieve transient hemostasis, it does not decrease transfusion dependence or supplant the long-term benefit of medical or operative therapy. Our data suggest that endoscopic management of MLT be limited to diagnostic procedures, including esophagogastroduodenoscopy, ileocolonoscopy, and wireless capsule endoscopy, which remain valuable in the evaluation of the distribution and severity of the disease.
8. Holland KE, Frieden IJ, Wyatt D, Frommelt PC, Drolet BA. Hypoglycemia in children taking propranolol for the treatment of infantile hemangiomas. Arch Dermatol. 2010; 146(7):775-8.
- Although propranolol has a long history of safe and effective use in infants and children for the treatment of many conditions, understanding and recognizing the possible harmful and adverse effects of this course of therapy is critical for physicians and caregivers. This is especially important when new medical indications evolve as physicians who may not be as familiar with propranolol and its adverse effects begin to recommend it as therapy (as in the treatment of IH). Our purpose is to highlight this idiosyncratic reaction and increase awareness for both the prescribing physician and the emergent care provider who may be caring for the child in an acute setting. Clearly outlined and safe protocols for initiation and chronic dosage should be developed in conjunction with randomized trials that document the effectiveness of propranolol in the treatment of IH.
9. Drolet BA, Chamlin SL, Garzon MC, Adams D, Baselga E, Haggstrom AN, Holland KE, Horii KA, Juern A, Lucky AW, Mancini AJ, McCuaig C, Metry DW, Morel KD, Newell BD, Nopper AJ, Powell J, Frieden IJ. A Prospective Study of Spinal Anomalies in Children with Infantile Hemangiomas of the Lumbosacral Skin. J Pediatr. 2010; 157(5):789-94.
- A multicenter prospective cohort study was performed at 9 Hemangioma Investigator Group sites to prospectively evaluate a group of patients with infantile hemangioma in the midline lumbosacral region for spinal anomalies to determine the positive predictive value of infantile hemangioma for occult spinal anomalies and to make evidence-based recommendations for screening. Infants and children with midline lumbosacral infantile hemangiomas are at increased risk for spinal anomalies. Screening magnetic resonance imaging is recommended for children with these lesions.
10. Kelly ME, Juern AM, Grossman WJ, Schauer DW, Drolet BA. Immunosuppressive effects in infants treated with corticosteroids for infantile hemangiomas. Arch Dermatol. 2010; 146(7):767-74.
- Corticosteroids have been the mainstay for treating such hemangiomas. However, prospective studies evaluating their immunosuppressive effects in infants with hemangiomas are lacking. Our results demonstrate that corticosteroids measurably affect both lymphocyte cell numbers and function in this patient population. Our study results have practical implications for the care of patients with hemangiomas undergoing medical treatment. Given the extent of lymphocyte depletion and compromised ability to respond to immunization, we would recommend that for all patients who received oral corticosteroids during the immunization period, antibodies for tetanus and diphtheria be checked after corticosteroid therapy and that additional immunization be considered if the titers are not protective at that time. In addition, one should consider PCP prophylaxis with trimethoprim-sulfamethoxazole in this population, especially if corticosteroid treatment persists for 2 or more months, a recommendation that has also been suggested by others.
11. Horii KA, Drolet BA, Baselga E, Frieden IJ, Metry DW, Morel KD, Newell BD, Nopper AJ, Garzon MC; for the Hemangioma Investigator Group. Risk of Hepatic Hemangiomas in Infants with Large Hemangiomas. Arch Dermatol. 2010; 146(2):201-203.
- To our knowledge, this is the first attempt to prospectively assess the risk of hepatic hemangiomas in infants with large cutaneous hemangiomas. Our findings suggest that infants with large cutaneous hemangiomas (>30cm2) may not be at an increased risk for concomitant hepatic hemangiomas as initially reported in the literature and as seen in infants with multiple cutaneous hemangiomas.
Other Recent Publications from VAC Physicians and Collaborators
1. Martin K, Bleib F, Chamlin SL, Chiu YE, Frieden IJ, Frommelt PC, Garzon MC, Kwon EK, Maclellan-Tobert S, Mancini AJ, Seefeldt M, Sidbury R, Siegel DH, Drolet BA, Boucek RJ. Propranolol treatment of infantile hemangiomas: anticipatory guidance for parents and caretakers. Pediatr Dermatol. 2013;30(1):155-9.
2. Kwon EK, Seefeldt M, Drolet BA Infantile Hemangiomas : An Update. Am J Clin Dermatol. 2013 Jan 22 [epub ahead of print].
3. Martin K, Bleib F, Chamlin SL, Chiu YE, Frieden IJ, Frommelt PC, Garzon MC, Kwon EK, Maclellan-Tobert S, Mancini AJ, Seefeldt M, Sidbury R, Siegel DH, Drolet BA, Boucek RJ. Propranolol treatment of infantile hemangiomas: anticipatory guidance for parents and caretakers. Pediatr Dermatol. 2013 Jan;30(1):155-9.
4. Schumacher WE, Drolet BA, Maheshwari M, Horii KA, Nopper AJ, Newell BD, Metry DW, Garzon MC, Morel KD, Chamlin SL, Mancini AJ, Frieden IJ, Johnson CM. Spinal dysraphism associated with the cutaneous lumbosacral infantile hemangioma: a neuroradiological review. Pediatr Radiol. 2012; 42(3):315-20.
5. Haggstrom AN, Beaumont JL, Lai JS, Adams DM, Drolet BA, Frieden IJ, Garzon MC, Holland KE, Horii KA, Lucky AW, Mancini AJ, Metry DW, Morel KD, Newell BD, Nopper AJ, Siegel D, Swigonski NL, Cella D, Chamlin SL Measuring the severity of infantile hemangiomas: instrument development and reliability. Arch Dermatol. 2012;148(2):197-202.
6. Glick ZR, Frieden IJ, Garzon MC, Mully TW, Drolet BA. Diffuse neonatal hemangiomatosis: An evidence-based review of case reports in the literature. J Am Acad Dermatol. 2012; 67(5):898-903.
7. Smith WA, Taintor AR, Kos L, Drolet BA. Senna-containing laxative inducing blistering dermatitis in toddlers. Arch Dermatol. 2012;148(3):402-4.
8. Mitchell S, Siegel DH, Shieh JT, Stevenson DA, Grimmer JF, Lewis T, Metry D, Frieden I, Blei F, Kayserili H, Drolet BA, Bayrak-Toydemir P. Candidate locus analysis for PHACE syndrome. Am J Med Genet A. 2012;158A(6):1363-7.
9. Rivière JB, Mirzaa GM, O'Roak BJ, Beddaoui M, Alcantara D, Conway RL, St-Onge J, Schwartzentruber JA, Gripp KW, Nikkel SM, Worthylake T, Sullivan CT, Ward TR, Butler HE, Kramer NA, Albrecht B, Armour CM, Armstrong L, Caluseriu O, Cytrynbaum C, Drolet BA, Innes AM, Lauzon JL, Lin AE, Mancini GM, Meschino WS, Reggin JD, Saggar AK, Lerman-Sagie T, Uyanik G, Weksberg R, Zirn B, Beaulieu CL, Finding of Rare Disease Genes (FORGE) Canada Consortium, Majewski J, Bulman DE, O'Driscoll M, Shendure J, Graham JM Jr, Boycott KM, Dobyns WB. De novo germline and postzygotic mutations in AKT3, PIK3R2 and PIK3CA cause a spectrum of related megalencephaly syndromes. Nat Genet. 2012; 44(8):934-40.
10. Tangtiphaiboontana J, Hess CP, Bayer M, Drolet BA, Nassif LM, Metry DW, Barkovich AJ, Frieden IJ, Fullerton HJ. Neurodevelopmental Abnormalities in Children With PHACE Syndrome. J Child Neurol. 2012 Jul 17 [epub ahead of print].
11. Metry D, Frieden IJ, Hess C, Siegel D, Maheshwari M, Baselga E, Chamlin S, Garzon M, Mancini AJ, Powell J, Drolet BA. Propranolol Use in PHACE Syndrome with Cervical and Intracranial Arterial Anomalies: Collective Experience in 32 Infants. Pediatr Dermatol. 2012; 30(1):71-89.
12. Mitchell S, Siegel DH, Shieh JT, Stevenson DA, Grimmer JF, Lewis T, Metry D, Frieden I, Blei F, Kayserili H, Drolet BA, Bayrak-Toydemir P. Candidate locus analysis for PHACE syndrome. Am J Med Genet A. 2012;158A(6):1363-7.
13. Siegel DH, Tefft KA, Kelly T, Johnson C, Metry D, Burrows P, Pope E, Cordisco M, Holland KE, Maheshwari M, Keith P, Garzon M, Hess C, Frieden IJ, Fullerton HJ, Drolet BA. Stroke in children with posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities (PHACE) syndrome: a systematic review of the literature.Stroke. 2012 Jun;43(6):1672-4.
14. Mirzaa GM, Conway RL, Gripp KW, Lerman-Sagie T, Siegel DH, deVries LS, Lev D, Kramer N, Hopkins E, Graham JM Jr, Dobyns WB. Megalencephaly-capillary malformation (MCAP) and megalencephaly-polydactyly-polymicrogyria-hydrocephalus (MPPH) syndromes: two closely related disorders of brain overgrowth and abnormal brain and body morphogenesis. Am J Med Genet A. 2012 Feb;158A(2):269-91.
15. Aboutalebi A, Jessup CJ, North PE, Mihm MC Jr. Histopathology of vascular anomalies. Facial Plast Surg. 2012;28(6):545-53.
16. Noel RJ, Duffy KJ, Kelly ME, Tondravi N, North PE, Drolet BA. Endoscopic management of gastrointestinal bleeding from multifocal lymphangioendotheliomatosis with thrombocytopenia: limited efficacy and complications.J Pediatr Gastroenterol Nutr. 2012;54(6):822-4.
17. Barranco-Pons R, Burrows PE, Landrigan-Ossar M, Trenor CC 3rd, Alomari AI. Gross hemoglobinuria and oliguria are common transient complications of sclerotherapy for venous malformations: review of 475 procedures. AJR Am J Roentgenol. 2012 Sep;199(3):691-4.
18. Macit B, Burrows PE, Yilmaz S, Orbach DB, Mulliken JB, Alomari AI. Cerebrofacial venous anomalies, sinus pericranii, ocular abnormalities and developmental delay. Interv Neuroradiol. 2012;18(2):153-7.
19. Kurek KC, Howard E, Tennant LB, Upton J, Alomari AI, Burrows PE, Chalache K, Harris DJ, Trenor CC 3rd, Eng C, Fishman SJ, Mulliken JB, Perez-Atayde AR, Kozakewich HP. PTEN hamartoma of soft tissue: a distinctive lesion in PTEN syndromes. Am J Surg Pathol. 2012;36(5):671-87.
20. Imteyaz H, Karnsakul W, Levine MA, Burrows PE, Benson J, Hsu S, Schwarz KB. Unusual case of hypothyroidism in an infant with hepatic hemangioma. J Pediatr Gastroenterol Nutr. 2012;54(5):692-5.
21. Horii KA, Drolet BA, Frieden IJ, Baselga E, Chamlin SL, Haggstrom AN, Holland KE, Mancini AJ, McCuaig CC, Metry DW, Morel KD, Newell BD, Nopper AJ, Powell J, Garzon MC. Hemangioma Investigator Group Prospective study of the frequency of hepatic hemangiomas in infants with multiple cutaneous infantile hemangiomas. Pediatr Dermatol. 2011; 28(3):245-53.
22. Daramola OO, Chun RH, Nash JJ, Drolet BA, North PE, Jensen JN, Kerschner JE. Surgical treatment of infantile hemangioma in a multidisciplinary vascular anomalies clinic. Int J Pediatr Otorhinolaryngol. 2011; 75(10):1271-4.
23. Haggstrom AN, Skillman S, Garzon MC, Drolet BA, Holland K, Matt B, McCuaig C, Metry DW, Morel K, Powell J, Frieden IJ. Clinical spectrum and risk of PHACE syndrome in cutaneous and airway hemangiomas. Arch Otolaryngol Head Neck Surg. 2011; 137(7):680-7.
24. Deyrup AT, Miettinen M, North PE, Khoury JD, Tighiouart M, Spunt SL, Parham D, Shehata BM, and Weiss SW. Pediatric cutaneous angiosarcomas: a clinicopathological study of 10 cases. Am J Surg Pathol 35(1):70-75, 2011.
25. Chaudry G, Burrows PE, Padua HM, Dillon BJ, Fishman SJ, Alomari AI. Sclerotherapy of abdominal lymphatic malformations with doxycycline. J Vasc Interv Radiol 201;22(10):1431-5.
26. Alomari AI, Chaudry G, Rodesch G, Burrows PE, Mulliken JB, Smith ER, Fishman SJ, Orbach DB. Complex spinal-paraspinal fast-flow lesions in CLOVES syndrome: analysis of clinical and imaging findings in 6 patients. AJNR Am J Neuroradiol 2011;32(10):1812-7 .
27. Thiex R, Mulliken JB, Revencu N, Boon LM, Burrows PE, Cordisco M, Dwight Y, Smith ER, Vikkula M, Orbach DB . A novel association between RASA1 mutations and spinal arteriovenous anomalies. AJNR Am J Neuroradiol 2010;31(4):775-9.
28. Juern A, Glick Z, Drolet BA, Frieden IJ. Nevus Simplex: Reappraisal of location, nomenclature, and associations. J Am Acad Dermatol. 2010; 63(5):805-14.
29. Arneja JS, Chim H, Drolet BA, Gosain AK. The cyrano nose: Refinements in surgical technique and treatment approach to hemangiomas of the nasal tip. Plast Reconstr Surg. 2010;126(4):1291-9.
30. Theos A, Hammers Y, Becum K, Drolet, BA, North P. Multiple congenital red-brown macules,thrombocytopenia and gastrointestinal bleeding. Pediatr Dermatol. 2010; 27(4):395-6.
31. Haggstrom AN, Garzon MC, Adams D, Baselga E, Chamlin SL, Frieden IJ, Holland K, Mancini AJ, McCuaig C, Metry DW, Morel K, Lucky A, Powell J, Perkins S, Siegel D, Drolet BA. A prospective study examining the risk for PHACE syndrome in infants with large facial hemangiomas. Pediatrics. 2010; 126(2):e418-26.
32. Hess CP, Fullerton HJ, Metry DW, Drolet BA, Siegel DH, Auguste KI, Gupta N, Haggstrom AN, Dowd CF, Frieden IJ, Barkovich AJ. Cervical and intracranial arterial anomalies in 70 patients with PHACE syndrome. AJNR Am J Neuroradiol. 2010; 31(10):1980-6.
33. Chim H, Drolet BA, Duffy K, Koshima I, Gosain AK. Vascular anomalies and lymphedema. Plast Reconstr Surg. 2010; 126(2):55e-69e.
34. Duffy KJ, Runge-Samuelson C, Bayer ML, Friedland D, Sulman C, Kerschner J, Metry D, Adams D, Drolet BA. Association of hearing loss with PHACE syndrome. Arch Dermatol. 2010; 146(12):1391-6.
35. Feramisco JD, Tsao H, Siegel DH. Genetics for the practicing dermatologist. Semin Cutan Med Surg. 2010 ;29(2):127-36.
36. Le Huu AR, Jokinen CH, Ruben BP, Bruckner A, Weiss SW, North PE, and Dadras SS. Expression of PROX1, lymphatic endothelial transcription factor, in kaposiform hemangioendothelioma and tufted angioma. Am J Surg Pathol 34(11):1563-73, 2010.
37. Benoit MM, North PE, McKenna MJ, Mihm MC, Johnson MM, and Cunningham MJ.Facial nerve hemangiomas: vascular tumors or malformations? Otolaryngol - Head & Neck Surg 142(1): 108-114, 2010.
38. Campbell CA, Beckum KM, Hammers YA, North PE, Drolet BA. Multiple congenital redbrown macules, thrombocytopenia, and gastrointestinal bleeding. Diagnosis: Multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT). Ped Dermatol 27(4):395-6, 2010.
39. Le Huu AR, Jokinen CH, Rubin BP, Mihm MC, Weiss SW, North PE, Dadras SS. Expression of prox1, lymphatic endothelial nuclear transcription factor, in Kaposiform hemangioendothelioma and tufted angioma. Am J Surg Pathol. 2010;34(11):1563-73.
40. Benoit MM, North PE, McKenna MJ, Mihm MC, Johnson MM, Cunningham MJ. Facial nerve hemangiomas: vascular tumors or malformations? Otolaryngol Head Neck Surg. 2010;142(1):108-14.
41. Alomari AI, Orbach DB, Mulliken JB, Bisdorff A, Fishman SJ, Norbash A, Alokaili R, Lord DJ, Burrows PE. Klippel-Trenaunay syndrome and spinal arteriovenous malformations: an erroneous association. AJNR Am J Neuroradiol 2010;31(9):1608-12.
42. Kulungowski AM, Fox VL, Burrows PE, Alomari AI, Fishman SJ. Portomesenteric venous thrombosis associated with rectal venous malformations. J Pediatr Surg 2010;45(6):1221-7.
43. Iacobas I, Burrows PE, Frieden IJ, Liang MG, Mulliken JB, Mancini AJ, Kramer D, Paller AS, Silverman R, Wagner AM, Metry DW. LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies. J Pediatr 2010;157(5):795-801.
44. Alomari AI, Burrows PE, Lee EY, Hedequist DJ, Mulliken JB, Fishman SJ. CLOVES syndrome with thoracic and central phlebectasia: increased risk of pulmonary embolism. J Thorac Cardiovasc Surg 2010;140(2):459-63.