Original articlePropranolol for treatment of ulcerated infantile hemangiomas
Introduction
Ulceration is the most common complication of infantile hemangioma (IH). It can result in pain, infection, bleeding, scarring and interfere with sleeping or feeding, all of which may adversely affect the quality of life of the child and its family.
Management of ulcerated IH includes analgesia, wound care, and antibiotics, if required for secondary infection.1, 2 Other treatment modalities include systemic corticosteroids,3 intralesional corticosteroids, flashlamp pulsed-dye laser therapy (FPDL), interferon-alfa, and vincristine. Complete wound healing may take almost 3 months with any treatment regimen.1
Although propranolol is now widely used to treat severe IH,4, 5 it has not been evaluated specifically for ulcerated IH. The objective of this observational study was to describe the therapeutic response, tolerance, and safety of propranolol in a population of infants with ulcerated IH.
Section snippets
Patients and methods
We conducted a national retrospective observational study. All consecutive cases of ulcerated IH evaluated by members of the French “Groupe de Recherche Clinique en Dermatologie Pédia-trique” from Jan 1, 2008 to Sept 1, 2009 were eligible.
Results
Thirty-five patients from 12 centers were identified. One patient was excluded because of lack of follow-up, and another did not meet the inclusion criteria. The remaining 33 cases were included in the analysis.
Discussion
In this retrospective study of 33 children treated with propranolol for ulcerated IH, complete pain control was achieved within a mean time of 14.5 days and at least 30 of 33 ulcers healed within a median time of 4.3 weeks.
Rapid pain control was the most striking effect of propranolol in our study. As recently reviewed by Storch and Hoeger,7 the early therapeutic effect of propranolol on IH may be explained by vasoconstriction. We postulate that pain relief in ulcerated IH is mainly due to this
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Cited by (0)
Funding sources: None.
Conflicts of interest: None declared.