Journal of Clinical & Experimental Dermatology Research
Open Access

Abstract

Natural History of Lymphatic Malformation Progression in Children: A Retrospective Study

Viraat Patel, Joanna H. Tu and Joyce M. C. Teng

Background/Objectives: Lymphatic malformation (LM) is a challenging lifetime disorder that can significantly impact children’s lives, and a key challenge in management is knowing when interventions might be appropriate. The purpose of this study was to determine (i) natural progression of complications associated with lymphatic malformations during childhood and adolescence, (ii) risk factors associated with complications, and (iii) whether early intervention decreases LM complication rates in adolescents or young adults.
Methods: Pediatric patients with LMs of soft tissue and integument were included in the study. Clinical records were reviewed for demographic data, progression, and interventions.
Results: The study comprised 293 pediatric patients (<20 years of age), including 157 females and 136 males. The delayed diagnosis of LM at an older age was associated with higher risk of complication (p<0.0001). The odds ratios of complications for patients between 5-10; 10-15; and 15-20 years of age vs. those between 0-5 years of age was 1.81 (95% confidence interval: 0.97-3.40); 0.83 (95% confidence interval: 0.38-1.82) and 2.08 (95% confidence interval: 0.71-6.11), respectively. In the multivariate analysis, the odds ratio of complications between patients with no treatment vs. those with treatment was statistically significant at 2.82 (95% confidence interval: 1.42-5.63).
Conclusions: In this study, we found a trend of increased complication rates in children over the age of 5 compared to early childhood between birth and 5 years of age. Delayed diagnosis at an older age therefore associates with significant risk of complication. This is also consistent with the finding that patients who did not receive treatment were nearly three times as likely to experience complications compared to patients who received an intervention before 20 years of age.