Table 3.

Previously Reported Scoring Systems for IHs

Abbreviation	Full Name	Year	Developer	Overview	Strengths	Limitations
HAS	The Hemangioma Activity Score	2011	Janmohamed20	The HAS is designed to assess the proliferative activity of IHs, utilizing swelling, color, and ulceration as objective measures	–Does not require measuring the size of the lesion –Suitable for objectively assessing a worsening or improvement of lesions –Appropriate for a retrospective analysis of photography	–Not suitable for comparing severity between different patients –Does not consider the anatomical location or size for assessments
HSS and HDCS	The Hemangioma Severity Scale and the Hemangioma Dynamic Complication Scale	2012	Haggstrom21	HSS offers a severity score for IHs by considering factors like size, location, and systemic anomaly risk factors, aiming to standardize a clinical severity measurement. HDCS, used in conjunction with HSS, evaluates complications of IH longitudinally	–Demonstrates high inter- and intrarater reliabilities (99%) –Incorporates subjective factors, such as pain, into the assessment –Evaluated by multiple review studies, serves as both a triage tool and treatment predictor	–Time consuming to apply –Not suitable for retrospective photograph analysis
HASI	Hemangioma Activity and Severity Index	2015	Semkova22	The HASI is comprised of two sections: one evaluates disease activity based on changing features, whereas the other assesses the severity, including complication risks	–Combines the advantages of both the HAS and HSS	–Not well reviewed in terms of treatment outcomes or selection
IHReS	The Infantile Hemangioma Referral Score	2020	Léauté-Labrèze et al23	A 2-part algorithm consisting of 12 questions, The IHReS aids nonexpert primary care physicians in making timely referrals to specialists	–An easy-to-use scoring system –Effective in reflecting a specialist’s diagnosis	–Not suitable for specialists’ use in selecting treatments – Not well reviewed in terms of treatment outcomes or selection