Infantile Hemangioma: A Current Review

Pahl, Kristy S.; McLean, Thomas W.

doi:10.1097/mph.0000000000002384

Cited by 8 publications

(6 citation statements)

References 132 publications

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“…They may go through gradual and spontaneous involution, but in some cases, depending on their location, they can lead to severe complications, ulceration, bleeding organ dysfunction or transient to permanent deformity which significantly impact patient and family quality of life. Propranolol has changed the history and the management of infantile hemangiomas [27], because of facility of administration and high success rate, becoming the first line treatment before glucocorticoids and surgery [28]. Although the mechanism underlying its effect is still unclear and controversies about side effects and potential safety issues [29].…”

Section: Dermatology 1-hemangioma; 2-epidermolysis Bullosa; 3-congeni...mentioning

confidence: 99%

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Caffarelli,

Santamaria,

Piro

et al. 2023

Ital J Pediatr

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The last year saw intensive efforts to advance knowledge in pediatric medicine. This review highlights important publications that have been issued in the Italian Journal of Pediatrics in 2022. We have chosen papers in the fields of allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology. Novel valuable developments in epidemiology, pathophysiology, prevention, diagnosis and treatment that can rapidly change the approach to diseases in childhood have been included and discussed.

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Section: Dermatology 1-hemangioma; 2-epidermolysis Bullosa; 3-congeni...mentioning

confidence: 99%

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Caffarelli,

Santamaria,

Piro

et al. 2023

Ital J Pediatr

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“…IHs are characterized by a predictable course and experience three stages: proliferation, a plateau phase, and involution ( 16 ). The morphology of IHs mainly depends on their location.…”

Section: Clinical Characteristics and Associated Congenital Syndromesmentioning

confidence: 99%

Management of infantile hemangiomas: Recent advances

Wang

Zhao

2022

Front. Oncol.

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Infantile hemangiomas (IHs) are benign vascular tumors commonly observed in children. A small number of cases can manifest as organ or system dysfunction, permanent scarring, or even disfigurement. Currently, diagnosis is mainly based on clinical history, physical examination, and auxiliary inspection. In the treatment of a hemangioma, the functional damage caused by the lesion and complications that may endanger the patient’s life should be given priority. This suggests that identification, diagnosis, and referral to specialists during the early stages of IHs are important factors in preventing related complications and obtaining a better prognosis. During the past few decades, researchers have explored different treatments according to the condition, including oral or topical drugs, topical drug injections, laser surgery, and surgical treatment. However, oral propranolol remains a well-accepted first-line treatment. This article will primarily focus on the recent advances in the clinical diagnosis and treatment of hemangiomas, along with a literature review on the subject.

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“…Specific risk factors, such as low birth weight, prematurity, fertility medications, female gender, white race, and family history are associated with (IH) development. Untreated IH can result in significant physical disfigurement due to ulceration and scarring of skin lesions (4) .…”

Section: Introductionmentioning

confidence: 99%

Topical Propranolol Hydrochloride Nanoemulsion: A Promising Approach Drug Delivery for Infantile Hemangiomas

Abdullah,

Al-Kinani

2023

IJPS

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Infantile hemangioma (IH) is a prevalent vascular tumor that affects up to 10% of infants worldwide. If left untreated, IH can lead to a permanent notable physical disfigurement due to skin lesions' ulceration and scarring. Oral propranolol hydrochloride (PHCl) is the only (FDA) approved, first-line treatment for infantile hemangioma (IH), but systemic exposure to propranolol HCl can cause serious adverse reactions. To reduce the risk of adverse effects, topical delivery is preferred due to its ability to provide high local drug concentration and fewer systematic side effects. However, PHCl is (BCS class I) is highly hydrophilic (LogP 1.2), which makes it challenging to be dermally delivered and penetrate the stratum corneum (SC) barrier. Oil in water o/w nanoemulsion (NE) was the chosen pharmaceutical technique to be utilized to solve this obstacle and counteract the difficulty of topical application. Propranolol was formulated as a NE employing clove as an oil phase, Tween 20 as surfactant and )PEG400 or PG( as a co-surfactants. Ten formulas were prepared, and different tests were accomplished to ensure the stability of the NEs, such as electrical conductivity, globule size, polydispersity index, percent of light transmittance (T%), dilution test, pH, zeta potential, drug content, viscosity and in-vitro drug release. Results of characterization revealed that PHCl nanoemulsion (F5) with (clove oil 10%) (Smix 60% of Tween20:PEG400 in a ratio of 3:1) and (DI DW 30%) is the optimum formula, since it has an electrical conductivity of (79 µS/cm), globule size of (14.87 nm), low PDI (0.282), light transmittance T% of (98.09), superior dilution without turbidity, pH value of (6.63), zeta potential (-24.91 mV), percent of drug content (99.79 %) with high viscosity (314.3 mpa.s at 6 rpm), and complete slow-release of the drug after (2hr). The preferred formula (F5) was subjected to further analysis by FTIR spectrophotometer. The findings indicated that the distinguishing peaks for PHCl remained unaffected, and we can conclude that there was no interaction between the drug and other NE constituents. In conclusion, the NE can be considered as an innovative approach to enhance the transport of drug molecules efficiently by overcoming the barrier properties of the skin (IH), despite the high hydrophilic properties of such drugs. الورم الوعائي الطفلي هو ورم وعائي واسع الانتشار يصيب ما يصل إلى 10٪ من الأطفال حول العالم. إذا تركت دون علاج، يمكن أن يؤدي إلى تشوه دائم ملحوظ بسبب تقرح وتندب الجلد. بروبرانولول هايدروكلورايد الفموي هو العلاج الوحيد المعتمد من إدارة الغذاء والدواء (FDA) للورم الوعائي الطفلي، ولكن التعرض الجهازي يمكن أن يسبب ردود فعل سلبية خطيرة. لتقليل مخاطر الآثار الضارة، يُفضل التوصيل الموضعي نظرًا لقدرته على توفير تركيز موضعي عالٍ وآثار جانبية جهازية أقل. ومع ذلك، فإن العقار (فئة BCS I) شديد المحبة للماء (LogP 1.2)، مما يجعل من الصعب توصيله عن طريق الجلد واختراق حاجز الطبقة المتقرنة (SC). المستحلب النانوي زيت في ماء، كان الأسلوب الصيدلاني المختار لاستخدامه في حل هذه العقبة ومواجهة صعوبة الاستعمال الموضعي. لقد تم تصييغ بروبرانولول على أنه مستحلب نانوي باستخدام زيت القرنفل كوسط زيتي، توين 20 كخافض للتوتر السطحي وPEG 400 اوPG كمواد مضادة للشد السطحي. تم تحضير عشرة تراكيب سائلة، وتم إجراء اختبارات مختلفة لها لضمان ثبات المستحلب النانوي مثل، التوصيل الكهربائي، حجم القطيرات، مؤشر التشتت المتعدد، ونسبة نفاذية الضوء (T٪)، اختبار التخفيف، درجة الحموضة، جهد زيتا، تقدير محتوى العقار، واللزوجة ونسبة تحرر العقار في المختبر. أظهرت نتائج التوصيف أن التركيبة (5) لمستحلب بروبرانولول التي تحتوي على (زيت القرنفل 10٪) (Smix 60٪ من توين 20: PEG 400 بنسبة 3:1) و (DI DW 30٪) هي التركيبة الافضل، لأنها تمتاز بموصلية كهربائية (79 µS / سم)، حجم قطيرات (14.87 نانومتر)، مؤشر تشتت منخفض (0.282)، نفاذية الضوء عالية T٪ (98.09)، تخفيف فائق بدون تعكر (تخفيفه بـ 20 جزءًا مائيا)، درجة الحموضة (6.63)، جهد زيتا (-24.91 مللي فولت)، محتوى العقار (99.79٪) مع لزوجة عالية (314.3 ميجا باسكال عند 6 دورة في الدقيقة)، وتحرر بطيء كامل للدواء بعد (ساعاتين). خضعت التركيبة المفضلة (5) لمزيد من التحليل مثل دراسة التوافق مع المكونات الاخرى بواسطة الفحص بالأشعة تحت الحمراء. أشارت النتائج إلى أن القمم المميزة للعقار ظلت غير متأثرة ويمكن أن نستنتج أنه لم يكن هناك تفاعل بين الدواء ومكونات المستحلب النانوي وكانت متسقة. في الختام، وجد أن المستحلب النانوي هو، وسيلة مبتكرة لتعزيز نقل جزيئات الدواء من خلال التغلب على خصائص حاجز الجلد (الورم الوعائي)، على الرغم من خصائص العقار العالية المحبة للماء.

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Infantile Hemangioma: A Current Review

Cited by 8 publications

References 132 publications

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Management of infantile hemangiomas: Recent advances

Topical Propranolol Hydrochloride Nanoemulsion: A Promising Approach Drug Delivery for Infantile Hemangiomas

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