Increased risk of symptomatic hemangiomas of the airway in association with cutaneous hemangiomas in a "beard" distribution

We evaluated the frequency of an association of cutaneous cervicofacial hemangiomas in a "beard" distribution (including the preauricular areas, chin, anterior neck, and lower lip) with symptomatic hemangiomas of the upper airway or subglottic areas. Of 529 patients seen, 187 were pediatric patients with hemangiomas of the head and neck. Sixteen of the 187 patients (8.5%) had cutaneous lesions with a beard distribution, with a score of 4 or greater. Ten of these 16 (63%) patients had some degree of symptomatic airway involvement, and four of the 10 (40%) required tracheotomy. The presence of cutaneous hemangiomas in a beard distribution should alert the evaluating physician to the potential association of upper airway or subglottic involvement.