This trial showed that propranolol was effective at a dose of 3 mg per kilogram per day for 6 months in the treatment of infantile hemangioma. (Funded by Pierre Fabre Dermatologie; ClinicalTrials.gov number, NCT01056341.).

Background: Hemangiomas of infancy are the most common tumors of childhood, and ulceration is the most common complication. Many treatments have been used for hemangioma ulceration, although none are uniformly effective. A recent report described the successful use of 0.01% becaplermin gel, a recombinant human platelet-derived growth factor, for an ulcerated hemangioma refractory to standard care. We sought to further assess the responsiveness of hemangioma ulceration to 0.01% becaplermin gel and to compare its cost to that of conventional modalities. Observations: We report a case series of 8 infants treated with becaplermin gel for ulcerated perineal hemangiomas of infancy. All infants were seen between January and June 2003 in the pediatric dermatology clinic at Texas Children's Hospital. Six female and 2 male infants were included. All of the hemangiomas were large (Ն6 cm 2), and of superficial or mixed superficial and deep morphology. Rapid ulcer healing occurred in all patients within 3 to 21 days (average, 10.25 days). Conclusions: In this small series, 0.01% becaplermin gel was a safe and effective treatment for perineal hemangioma ulceration. The rapid healing achieved with 0.01% becaplermin gel allows a reduction in the risk of secondary infection, pain, and need for hospitalization, as well as in the costs that often accumulate from multiple follow-up visits and long-term therapy.

Congenital erosive and vesicular dermatosis healing with reticulated supple scarring is a rare disorder of unknown etiology first reported in three patients in 1985. Nine patients have subsequently been reported, helping to further characterize this unique dermatosis. We describe another patient and further describe the histologic and electron microscopic findings of this entity. This case is unique in that histologic distinction is made between vesicular and scarred lesions.

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These data provide evidence for the presence of a subtype of LAD with dual IgA and IgG autoimmune response to BP180.