It is generally applied two to three times daily. Surgery
Surgical excision of hemangiomas is rarely indicated, and limited to lesions which fail medical therapy (or when it is contraindicated), which are anatomically distributed in a location which is amenable to resection, and in which resection would likely be necessary and the scar will be similar regardless of timing of the surgery. Surgery may also be useful for removal of residual fibrofatty tissue (following hemangioma involution) and reconstruction of damaged structures. Laser
Laser therapy, most often the pulsed dye laser (PDL), plays a limited role in hemangioma management. PDL is most often used for treatment of ulcerated hemangiomas, often in conjunction with topical therapies and wound care, and may speed healing and diminish pain. Laser therapy may also be useful for early superficial IHs (although rapidly proliferating lesions may be more prone to ulceration following PDL treatment), and for the treatment of cutaneous telangiectasias which persist following involution. Prognosis
In the involution phase, an IH finally begins to diminish in size. While IHs were previously thought to improve by about 10% each year, newer evidence suggests that maximal improvement and involution is typically reached by 3.5 years of age. Most IHs resolve by age 10, but in some patients, the hemangioma does not completely resolve. Residual redness may be noted and can be improved with laser therapy, most commonly PDL. Ablative fractional resurfacing may be considered for textural skin changes.
Bronchoscopic, video-assisted, or open lung biopsy allows the histological characterization of pulmonary lesions, which can distinguish rheumatoid lung disease from other interstitial lung diseases.The following tests may also show signs of rheumatoid lung disease:
Chest x-ray may show:
pleural effusion
lower zone predominant reticular or reticulonodular pattern
volume loss in advanced disease
skeletal changes, e.g. erosion of clavicles, glenohumeral erosive arthropathy, superior rib notching
Chest CT or HRCT features include:
pleural thickening or effusion
interstitial fibrosis
bronchiectasis
bronchiolitis obliterans
large rheumatoid nodules
single or multiple
tend to be based peripherally
may cavitate (necrobiotic lung nodules)
cavitation of a peripheral nodule can lead to pneumothorax or haemopneumothorax. follicular bronchiolitis
small centrilobular nodules or tree-in-bud
rare
Caplan syndrome
Echocardiogram (may show pulmonary hypertension)
Lung biopsy (bronchoscopic, video-assisted, or open), which may show pulmonary lesions
Lung function tests
Needle inserted into the fluid around the lung (thoracentesis)
Blood tests for rheumatoid arthritis

Treatment
Many people with this condition have no symptoms. Treatment is aimed at the health problems causing the lung problem and the complications caused by the disorder.Fast-acting drugs for RA include aspirin and corticosteroids, which alleviate pain and reduce inflammation. Slow-acting drugs termed disease modifying antirheumatic drugs (DMARDs), include gold, methotrexate and hydroxychloroquine (Plaquenil), which promote disease remission and prevent progressive joint destruction. In patients with less severe RA, pain relievers, anti-inflammatory drugs and physical rest are sufficient to improve quality of life. In patients with joint deformity, surgery is the only alternative for recovering articular function.Prognosis is related to the underlying disorder and the type and severity of lung disease. In severe cases, lung transplantation can be considered.