A Rating Scale in Determining Indications for Systemic Medicamentous Treatment of Infantile Hemangiomas With Beta-Blockers

Abstract

Introduction. Infantile hemangioma (IH) is the most common benign vascular tumor of childhood. Currently, the first line of IH therapy are beta-blockers (Propranolol, Atenolol). However, their application may cause some complications, like cardiac, pulmonary and others. Practitioners who are engaged in HI therapy should be well aware of criteria for prescribing such treatment. Up to now, there are no uniform criteria anywhere in the world when to start and to finish the systemic therapy with beta-blockers. Material and methods. We have developed a rating scale for determining indications for IH systemic treatment with beta-blockers which includes the following parameters: IH volumetric component (thickness), child’s age, IH location, IH dimensions, number of IH on the skin and complications. A physician examines a patient, analyzes the abovementioned criteria and summarizes scores. During the period from October 1, 2018 to May 31, 2019, the Center for Vascular Pathology conducted 923 initial consultations for children using an assessment scale (main group). During an 8-month period from February 1, 2018 to September 30, 2018, 879 children consulted without using an assessment scale were included in the comparison group. Results. After analyzing results in two compared groups , one can see a clear decrease in prescription of the medicamentous therapy by 1.5 times: from 43.3% to 27.3%. Conclusions. The discussed rating scale, developed for determining indications of IH systemic treatment with beta-blockers, objectively and reliably evaluates prescription of medicamentous therapy not only due to physician’s experience but also due to summarized indicators. Such an approach can produce a positive effect at the disease course. However, it is worth reminding that the proposed scale is more a proposed direction in choosing a technique for IH treatment.