A rare case of deep hemangioma presenting as a periorbital swelling and its excellent response to intralesional steroids

A hemangioma is a benign and usually self-involuting tumor of the endothelial cells of blood vessels, and is characterized by an increased number of normal or abnormal vessels. It usually appears in the first few weeks of life and grows most rapidly over the first six months. Usually, growth is complete and involution has commenced by twelve months. Half of all infantile hemangiomas involute by age five, 70% by age seven, and most of the remainder by age twelve. In more severe cases hemangiomas may leave residual tissue damage. The dermatologic indications for intervention in a case of hemangioma include maceration and erosion of the epidermis, infection, and cosmetic disfigurement. The treatment options include corticosteroids (oral), interferon, vincristine, propranolol, pulsed dye laser and surgery. The intralesional steroids are usually not recommended in the periocular region because of side effects like eyelid necrosis and central retinal vein occlusion. Here we report the case of a deep hemangioma in periorbital region with no overlying skin changes and its excellent response to intralesional steroids with no side effects.