New Online Tool For The Early Diagnosis And Referral Of Infantile Hemangioma Can Help Avoid Complications Stemming From Delayed Treatment


PARSIPPANY, N.J., Sept. 14, 2020 /PRNewswire/ -- A validation study highlighting the reliability and ease of use of the Infantile Hemangioma Referral Score (IHReS) for the early diagnosis, referral and treatment of infantile hemangioma (IH) was published recently in Pediatrics, as reported by Pierre Fabre Pharmaceuticals USA, Inc. IHReS (pronounced eye-rez), a 12-question, two-part algorithm was shown to help primary physicians facilitate the correct and timely referral of patients with IH to expert centers. The published study titled, The Infantile Hemangioma Referral Score: A Validated Tool for Physicians, is available here.  

"The early referral of patients with infantile hemangioma to a specialist is critical in preventing complications that can arise due to delayed treatment," said David Darrow, MD, DDS, Professor of Otolaryngology at Eastern Virginia Medical School and co-director of the Center for Hemangiomas and Vascular Birthmarks at Children's Hospital of The King's Daughters in Norfolk, VA. "This study validates the Infantile Hemangioma Referral Score as a simple and reliable tool that should reduce these delays by assisting primary care providers with medical decision-making earlier in the evaluation phase."

Colleen Cotton, MD, Assistant Professor, Division of Pediatric Dermatology at the Medical University of South Carolina, added her clinical experience with delayed treatment. "Unfortunately, I see many patients with hemangiomas when it's too late. More often than not, it's due to the misconception that the hemangioma will go away on its own. These young children usually need some form of corrective surgery because the hemangioma has significantly proliferated or even ulcerated. Hemangiomas that have ulcerated are extremely painful and can cause permanent scarring. Complications like this can be avoided with proper utilization of the Infantile Hemangioma Referral Score because it allows specialists to intervene early and develop a proper course of treatment."

About IHReS

IHReS aims to improve the decision making of primary physicians regarding the referral of patients that present with IH. The two-part algorithm contains 12 questions that when answered, directs the primary physician to either refer the patient to an IH specialist or actively monitor the patient. The IHReS tool contains good intrinsic properties (sensitivity 97% and specificity 55%), and is reliable, repeatable and simple-to-use. The IHReS website can be accessed through a computer, smartphone or tablet at

About Infantile Hemangiomas

Infantile hemangiomas are the most common benign vascular tumors of infancy – affecting up to 10% of all infants and up to 30% of premature babies.1 The lesions are rarely present at birth, but appear within the first few weeks of life.2 Among infants who present with hemangiomas, about 12% have complications that lead to ulceration, impaired vision, or disfigurement.3 The proliferation phase of IHs can extend up to six months of age or longer, with rapid growth occurring between 5.5 and 7.5 weeks.4-5 The involution phase of IHs can span over a period of 3 to 9 years.6 For the best outcome, the optimal age for referral to a specialist is 4 weeks so that therapy can be initiated before or early during the period of rapid growth.4  For more information about infantile hemangiomas, visit

About the Study

The multicenter, cross-sectional, observational study used a three-stage process which included: development of the IHReS tool by IH experts who selected a representative set of 42 IH cases comprised of images and a short clinical history; definition of the gold standard for the 42 cases by a second independent committee of IH experts; and IHReS validation by non-expert primary physicians using the 42 gold standard cases.


  • Sixty primary physicians from seven different countries evaluated the 42 gold standard cases (without reference to the IHReS tool), 45 primary physicians evaluated these cases using the IHReS questionnaire, and 44 completed retesting using the instrument.
  • IHReS had a sensitivity of 96.9% (95% confidence interval 96.1%-97.8%) and a specificity of 55% (95% confidence interval 51%-59%).
  • The positive predictive value and negative predictive value were 40.5% and 98.3%, respectively.
  • Validation by experts and primary physicians revealed substantial agreement for interrater reliability and intrarater repeatability.

About Pierre Fabre Pharmaceuticals USA, Inc.

Pierre Fabre Pharmaceuticals, a subsidiary of Pierre Fabre SA, is a private French company with a focus in medical dermatology. The Company leverages its pharmaceutical and dermo-cosmetic research and development among four areas of innovation including oncology, dermo-cosmetics, consumer healthcare and dermatological pharmaceuticals. Pierre Fabre Pharmaceuticals USA, Inc. is located in Parsippany, NJ.

The Pierre Fabre Group is the second largest dermo-cosmetics laboratory in the world and the second largest private French pharmaceutical group. It is majority owned by a government-recognized public-interest foundation (via decree dated April 6, 1999): the Pierre Fabre Foundation. For 20 years, the Pierre Fabre Foundation has been establishing and developing long-term programs with our network of local partners - hospitals, universities and patient associations - to provide the poorest populations with better access to prescription drugs and high-quality health care.

The Pierre Fabre Group's holding company, Pierre Fabre SA, establishes the overall strategy, consolidates and coordinates activities, and hosts shared services and support functions for the Group. Pierre Fabre Pharmaceuticals and Pierre Fabre Dermo-Cosmetique are the main subsidiaries of Pierre Fabre SA. For more information, visit



  1. Storch CH, Hoeger PH. Propranolol for infantile haemangiomas: insights into the molecular mechanisms of action. Br J Dermatol. 2010;163:269-274.
  2. Chen TS, Eichenfield LF, Friedlander SF. Infantile hemangiomas: an update on pathogenesis and therapy. Pediatrics. 2013;131(1):99-108.
  3. Drolet BA, Frommelt PC, Chamlin SL, et al. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics. 2013;131(1):128-140.
  4. Tollefson MM, Frieden IJ. Early growth of infantile hemangiomas: what parents' photographs tell us. Pediatrics. 2012;130(2):e314-e320.
  5. Leaute-Labreze C, Prey S, Ezzedine K. Infantile haemangioma: part I. Pathophysiology, epidemiology, clinical features, life cycle and associated structural abnormalities. J Eur Acad Dermatol Venereol. 2011;1-9.
  6. Bauland CG, Luning TH, Smit JM, Zeebregts CJ, Spauwen PHM. Untreated hemangiomas: growth pattern and residual lesions. Plast Reconstr Surg. 2011:127(4):1643-1648.


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SOURCE Pierre Fabre Pharmaceuticals USA, Inc.


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