Growth Characteristics of Infantile Hemangiomas: Implications for Management

Chang, Linda; Haggstrom, Anita N.; Drolet, Beth A.; Baselga, Eulàlia; Chamlin, Sarah L.; Garzon, María C.; Horii, Kimberly A.; Lucky, Anne W.; Mancini, Anthony J.; Metry, Denise; Nopper, Amy J.; Frieden, Ilona J.

doi:10.1542/peds.2007-2767

Cited by 597 publications

(554 citation statements)

References 26 publications

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“…Focal IHs are rarely present at birth and exhibit a characteristic growth phase typically up to the age of 9 months. 5 A gradual involution phase takes place over the subsequent 2 to 10 years 1,5 ; however, recently, Couto et al 6 suggested that most IHs do not substantially further improve after 3.5 years of age. Increasingly, nonselective b-blockers, including propranolol hydrochloride, have replaced or been used in conjunction with previously recommended treatments such as systemic corticosteroids and vincristine for the treatment of IHs to prevent ulceration and disfigurement and for systemic involvement.…”

Section: What This Study Addsmentioning

confidence: 99%

RCT of Timolol Maleate Gel for Superficial Infantile Hemangiomas in 5- to 24-Week-Olds

Chan¹,

McKay²,

Adams

et al. 2013

Pediatrics

131

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WHAT'S KNOWN ON THIS SUBJECT:The systemic nonselective b-blocker propranolol hydrochloride is increasingly used as firstline management for infantile hemangiomas. Superficial nonulcerating lesions do not require systemic medications. Case series have suggested the efficacy of timolol; however, its safety has been questioned. WHAT THIS STUDY ADDS:This randomized controlled trial indicates that timolol maleate 0.5% gel is a well-tolerated, safe, and effective treatment of superficial infantile hemangiomas. abstract OBJECTIVE: Timolol maleate 0.5% gel is a safe and effective medication for treating superficial infantile hemangiomas (IHs) in infants with a median age of 9 weeks.METHODS: Forty-one infants who had superficial IHs without ulceration and not near mucosal surfaces were recruited and randomly assigned to placebo and treatment (timolol maleate 0.5% gel) groups. Efficacy was assessed by performing blinded volume measurements at weeks 0, 1, 2, 3,4,8,12,16,20, and 24 and blinded investigator photograph scoring at weeks 0, 12, and 24. Safety was assessed by measuring heart rate and systolic and diastolic blood pressure at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20, and 24. RESULTS: Fifteen of the 19 infants receiving treatment and 17 of the 22 infants receiving placebo completed the study. Significant color change on the blinded photographic scores was noted at week 24 of the study (P = .003). There was a significantly higher proportion of treated IHs that reduced in size by .5% at weeks 20 and 24 (P , .02). The predicted proportion of IH volume change was also significantly less for treated IHs from week 16 onward when compared with placebo (P , .05). There was no significant variation in blood pressure and heart rate between the groups. CONCLUSIONS: Topical timolol maleate 0.5% gel with a maximum dose of 0.5 mg per day is a safe and effective option for small superficial IHs that have not ulcerated and are not on mucosal surfaces. Pediatrics

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Section: What This Study Addsmentioning

confidence: 99%

RCT of Timolol Maleate Gel for Superficial Infantile Hemangiomas in 5- to 24-Week-Olds

Chan¹,

McKay²,

Adams

et al. 2013

Pediatrics

131

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“…Большинство ИГ локализуются в области головы и шеи (60%), реже -на туловище (25%) и на конеч-ностях (15%) [9].…”

Section: клиническая картинаunclassified

Modern treatments of infantile hemangiomas

Vasilevskaya¹,

Vardanyan²,

Dzybova³

2015

Klin. dermatol. venerol.

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“…1 Typically they present shortly after birth, undergo a period of rapid proliferation, and then slowly involute over many years. 2,3 Although most are small cutaneous vascular malformations of the face, 4 they can also be large, disfiguring lesions with serious complications. Infants with large hemangiomas, especially those with a segmental distribution or hemangiomatosis, are at particular risk for extracutaneous complications.…”

Section: Introductionmentioning

confidence: 99%

The role of propranolol in the treatment of infantile hemangioma

Laranjo

Costa

Paramés

et al. 2014

Revista Portuguesa de Cardiologia

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Introduction: Infantile hemangioma (IH) is one of the most common childhood tumors. There are various medical or surgical therapeutic options, all with suboptimal results. Recently, the successful use of propranolol for involution of IH was described. We report the results of a single-center experience with this therapeutic option. Objective: To prospectively assess the efficacy and safety of propranolol in children with infantile hemangioma. Methods:We performed a prospective analysis of clinical data of all patients with IH referred to a pediatric cardiology center for baseline cardiovascular assessment prior to propranolol therapy. Propranolol was given at a starting dose of 1 mg/kg/day and titrated to a target dose of 2---3 mg/kg/day according to clinical response. Efficacy was assessed through a photographbased severity scoring scale. Safety was assessed by collecting data regarding significant side effects. Results: Starting in 2010, 30 patients (15 female) were referred for propranolol treatment of IH, at a median age of six months (1---63 months). The mean target propranolol dose was 2.8 mg/kg/day, with a mean duration of therapy of 12 months. All patients experienced significant reduction of IH size and volume. There were no side effects. Conclusions: In our experience propranolol appears to be a useful and safe treatment option for severe or complicated IH, achieving a rapid and significant reduction in their size. No adverse effects were observed, although until larger clinical trials are completed, potential adverse events should be borne in mind and consultation with local specialists is recommended prior to initiating treatment. PALAVRAS-CHAVE Hemangioma infantil; Propranolol O papel do propranolol no tratamento dos hemangiomas em idade pediátrica ResumoIntrodução: Os hemangiomas são a lesão tumoral cutânea mais frequente em idade pediátrica. Até ao momento todas as opções terapêuticas (tanto médicas como cirúrgicas) têm resultados sub-ótimos. Recentemente, foi descrita a utilização de propranolol para tratamento dos hemangiomas. Relatamos os resultados da nossa experiência com esta opção terapêutica. Objetivo: Avaliação prospetiva da eficácia e segurança de propranolol em crianças com hemangioma infantil. Métodos: Avaliação prospetiva de todos os doentes com hemangioma referenciados para avaliação cardiovascular prévia ao início de terapêutica com propranolol. O propranolol foi administrado numa dose inicial de 1 mg/kg/dia e titulada para uma dose alvo de 2---3 mg/kg/dia, de acordo com a resposta clínica. A eficácia foi avaliada através de uma escala fotográfica. A segurança foi avaliada através da recolha de dados sobre os efeitos secundários significativos. Resultados: Desde 2010, 30 crianças (15 do sexo feminino) com hemangiomas foram referenciados para avaliação cardiovascular prévia ao início de terapêutica beta-bloqueante, com uma idade média de 6 meses (1-63 meses). A dose alvo média atingida foi de 2,8 mg / kg / dia, com uma duração média de tratamento de 12 meses. Em todos os doe...

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Growth Characteristics of Infantile Hemangiomas: Implications for Management

Cited by 597 publications

References 26 publications

RCT of Timolol Maleate Gel for Superficial Infantile Hemangiomas in 5- to 24-Week-Olds

RCT of Timolol Maleate Gel for Superficial Infantile Hemangiomas in 5- to 24-Week-Olds

Modern treatments of infantile hemangiomas

The role of propranolol in the treatment of infantile hemangioma

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