What are the other Names for this Condition? (Also known as/Synonyms)

• HH (Hobnail Hemangioma)
• Hobnail Haemangioma
• Targetoid Hemosiderotic Hemangioma

What is Hobnail Hemangioma? (Definition/Background Information)

• Hemangiomas are benign malformation of blood vessels that can occur in a number of tissues such as the brain, kidney, liver, lung, skin, and nasal cavity
• Hobnail Hemangioma (HH) is an uncommon type of hemangioma, which are benign growths composed of small blood vessels that occur on the skin or within the skin tissues, anywhere in the body
• They are mostly present as solitary tumors presenting no significant signs and symptoms. The cause of development of Hobnail Hemangioma is not yet well understood. Some studies inform that trauma may play a role in its formation
• Hobnail Hemangiomas may not require any treatment. However, they may be treated for cosmetic purposes, or in case of severe and chronic bleeding
• The treatment options include the surgical removal of the tumor. The prognosis of Hobnail Hemangioma is generally excellent, since it is a benign tumor with no risk of recurrence

Who gets Hobnail Hemangioma? (Age and Sex Distribution)

• Hobnail Hemangiomas are rare skin tumors. They are mostly observed in young and middle-aged adults, though they may be found in other age group individuals too
• A preference for males is observed, even though both male and female genders are affected
• It can affect individuals of all races and ethnic backgrounds across the world

What are the Risk Factors for Hobnail Hemangioma? (Predisposing Factors)

• The specific risk factors that contribute to Hobnail Hemangioma development are unknown
• It is believed to arise as a reactive process, secondary to trauma, to other skin lesions

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hobnail Hemangioma? (Etiology)

The exact cause for development of Hobnail Hemangiomas is unknown.

• However, they may arise because of trauma or injury
• Some researchers believe that an injury to a lymphangioma or angiokeratoma may cause the formation of a HH

What are the Signs and Symptoms of Hobnail Hemangioma?

Hobnail Hemangiomas are generally asymptomatic and may not present any significant signs and symptoms.

• They occur on the skin (superficial location) or subcutaneously
• The hemangiomas may be present anywhere on the body, but are common in the legs (thigh), arms, and the chest and back area
• Infrequently, these lesions have been reported to occur in the mouth (including on the tongue and gums)
• These benign growths are small, usually single, and slow-growing. The size of the hemangioma does not exceed 2 cm
• Hobnail Hemangiomas may have a characteristic appearance with a raised, well-defined central lesion surrounded by a red or pigmented halo (following a bleeding episode). Hence, this tumor is also known as ‘Targetoid Hemosiderotic Hemangioma’
• Rarely, the hemangiomas may be multiple in numbers
• Sometimes, these benign tumors may rupture and bleed, if they are injured

How is Hobnail Hemangioma Diagnosed?

A diagnosis for Hobnail Hemangioma includes evaluating the clinical history (physical exam) and a thorough family history. Other tools to help diagnose the lesion may include:

• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Skin or tissue biopsies may be performed to diagnose hemangioma and to rule-out other conditions. The pathology reports can help in distinguishing it from other types of hemangiomas

Note: A Hobnail Hemangioma may be mistaken for a Kaposi sarcoma (a malignant tumor) in some cases. Hence, a careful examination and study of the tissue biopsy is often necessary to make an accurate diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hobnail Hemangioma?

The complications of Hobnail Hemangiomas may include:

• Bleeding following an injury or trauma
• Oral lesions may present significant difficulties during chewing/eating or talking
• Some individuals may feel stressed due to the presence of these lesions, or due to cosmetic concerns
• Damage to vital nerves, blood vessels, and surrounding structures during surgery to remove the tumor

How is Hobnail Hemangioma Treated?

Hobnail Hemangiomas do not cause any symptoms in most cases, and therefore may not require any treatment.

• In case of bleeding or cosmetic issues related to physical appearance, individuals may choose to remove them. In such cases, a surgical excision and removal of the tumor may be undertaken
• Post-operative follow-up care with regular screening and check-ups are recommended

The procedures for removing a hemangioma may include:

• Burning (electrosurgery/cautery)
• Freezing (cryotherapy)
• Laser surgical excision

How can Hobnail Hemangioma be Prevented?

Currently there are no specific methods or preventative techniques for the formation of Hobnail Hemangiomas.

What is the Prognosis of Hobnail Hemangioma? (Outcomes/Resolutions)

• The prognosis of Hobnail Hemangioma is excellent, since they are benign and generally asymptomatic tumors
• Local recurrences following tumor removal is not observed

Additional and Relevant Useful Information for Hobnail Hemangioma:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/cancer/