Intralesional Corticosteroid Therapy for Childhood Cutaneous Hemangiomas

Chowdri, Nisar Ahmad; Darzi, Mohammad Ashraf; Fazili, Zahoor; Iqbal, Shabir

doi:10.1097/00000637-199407000-00009

Cited by 40 publications

(24 citation statements)

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“…Subsequently, numerous studies have suggested that intralesional corticosteroid injection is a safe and effective treatment of IH. [210][211][212][213][214][215][216][217][218][219] In general, corticosteroid injection is reserved for small, bulky, welllocalized IH lesions. Large or diffuse IHs are more difficult to manage with intralesional corticosteroids because of the following: (1) a large volume of injectable steroid is more likely to cause systemic adverse effects 220 and (2) it is difficult to evenly distribute the corticosteroid throughout a large tumor.…”

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

“…However, in appropriately selected lesions, many authors consider intralesional corticosteroid injection an effective intervention, given its effectiveness and the relatively low frequency of reported systemic adverse effects at low doses (#2-3 mg/kg). [210][211][212][213][214][215][216][217][218][219] In most studies, patients were injected with either triamcinolone alone or a mixture of triamcinolone and betamethasone, at total equivalent doses of triamcinolone doses of ,3 mg/kg, by using a 27-or 30-gauge needle. 218 The interval between injections varied from 1 to 6 weeks.…”

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

“…208 After corticosteroid injection, large studies have reported accelerated regression in 77% to 100% of patients with IH and cessation of growth in 16% to 23%. [210][211][212][213][214][215][216][217][218][219] The effects of the steroid last approximately 3 to 4 weeks 216 and thus patients may require additional treatments during the proliferating phase for rebound growth.…”

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

“…[213][214][215] Systemic adverse effects, including cushingoid features (0%-3%) [213][214][215][216][217] and adrenal suppression, 220 can occur when very large doses of intralesional steroids are given ($5 mg/kg). A more serious complication of intralesional corticosteroid therapy occurs in lesions of the upper eyelid, with 3 cases of retinal embolization having been reported after an injection of corticosteroids into IHs in this region.…”

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

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Diagnosis and Management of Infantile Hemangioma

Darrow¹,

Mancini²,

Nopper³

et al. 2015

Pediatrics

211

290

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Infantile hemangiomas (IHs) are the most common tumors of childhood. Unlike other tumors, they have the unique ability to involute after proliferation, often leading primary care providers to assume they will resolve without intervention or consequence. Unfortunately, a subset of IHs rapidly develop complications, resulting in pain, functional impairment, or permanent disfigurement. As a result, the primary clinician has the task of determining which lesions require early consultation with a specialist. Although several recent reviews have been published, this clinical report is the first based on input from individuals representing the many specialties involved in the treatment of IH. Its purpose is to update the pediatric community regarding recent discoveries in IH pathogenesis, treatment, and clinical associations and to provide a basis for clinical decision-making in the management of IH.

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Section: Intralesional Corticosteroidsmentioning

confidence: 99%

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

Section: Intralesional Corticosteroidsmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis and Management of Infantile Hemangioma

Darrow¹,

Mancini²,

Nopper³

et al. 2015

Pediatrics

211

290

View full text Add to dashboard Cite

show abstract

“…Traditional management of hemangiomas has been based on the assumption that this birthmark will involute spontaneously by the age of 3 to 7 years. [1][2][3][4][5][6] Symptomatic problems such as ulceration, infection, bleeding, obstruction of orifices, or psychological factors may indicate the necessity of treatment. A number of alternative methods such as carbon dioxide snow, liquid nitrogen, and radiation therapy have been applied for treatment of hemangiomas, resulting in even more complications.…”

Section: Introductionmentioning

confidence: 99%

Long Term Follow-up of Intralesional Laser Photocoagulation (ILP) for Hemangioma Patients

Chang

2011

LASER THERAPY

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Background and Objectives: Hemangiomas remain a challenge for patients and plastic surgeons. Promising results have been reported using intralesional photocoagulation (ILP) for treatment. The objective of our study is to review the long term results of a large series of hemangiomas in patients treated by ILP. Materials (Subjects) and Methods: A retrospective review of 684 hemangiomas in patients were treated by ILP with an Nd:YAG (neodymium-yttrium-aluminium-garnet) (1064 nm) laser over a period of 10 years (January 1996 -January 2005). Patients' ages ranged from one month to 11 years 5 months (mean, 1 year 10 months). The patient group consisted of 474 females and 210 males. Results: Patients were treated with an Nd:YAG laser delivered through a 600 m optical fiber. Laser power was set at 7 to 15 watts (W) and delivered with pulse duration of 7 to 15 seconds (s). The results showed 603 (88.6%) patients had more than 50% reduction of the volume in hemangiomas at 3 months after one treatment; and 663 (96.9%) patients had more than 50% reduction of the volume at 3 months after two treatments. Patients who had continuous ILP achieved excellent results. Conclusions: Postoperative complications have been related to photocoagulation that has been delivered too extensively or superficially, with resultant ulceration, infection, bleeding, and scarring. These complications can be avoided if this potential for harm is kept in mind.

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In vitro and in vivo photosensitizing capabilities of 5-ALA versus Photofrin� in vascular endothelial cells

et al. 1999

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Background and Objective The objective of the present study was to evaluate the feasibility of photodynamic therapy (PDT) for complicated hemangiomas. The photosensitizing activities of 5‐aminolevulinic acid (5‐ALA) and Photofrin® were evaluated in vitro with human dermal microvascular endothelial cells (MEC) and in vivo with the chicken cox comb. Study Design/Materials and Methods The in vitro absorption and photosensitizing activities of 5‐ALA and Photofrin® were examined in a MEC culture system. The percentages of MEC killed by different drug concentrations at a wavelength of 630 nm were measured by either live/dead or lactate dehydrogenase‐released assays. Similarly, the in vivo biological activities of 5‐ALA and Photofrin® exposed to different total light dosages at 630 nm were studied by determining the amount of necrosis produced in chicken combs. Results MEC incubated with 5‐ALA at a concentration of 35 μg/ml and exposed to laser light at 630 nm at a power density of 100 mW/cm2 showed a 50% cell kill. MEC incubated with Photofrin® at a concentration of 3.5 μg/ml and exposed to laser light at 630 nm at a power density of 100 mW/cm2 showed a 50% cell kill. Chicken combs that received 200 mg/kg of 5‐ALA exposed to laser light at 630 nm at a power density of 100 mW/cm2 had an injury depth of 362.5 ± 27.6 μm at histologic examination. Combs exposed to a power density of 100 or 120 mW/cm2 showed injury depths of 732.5 ± 29.1 and 792.5 ± 36.0 μm, respectively. Chicken combs that received 2.5 mg/kg of Photofrin® exposed to laser light at 630 nm at a power density of 80 mW/cm2 had an injury depth of 535.6 ± 22.3 μm at histologic examination. Combs exposed to a power density of 100 or 120 mW/cm2 showed injury depths of 795.8 ± 32.5 and 805.2 ± 49.1 μm, respectively. Conclusion Both 5‐ALA and Photofrin® have the capability to destroy MEC in vitro and vasculature in vivo. However, Photofrin® achieved a higher degree of cell kill and tissue destruction at lower drug concentrations and at lower power densities. Lasers Surg. Med. 24:178–186, 1999. © 1999 Wiley‐Liss, Inc.

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Intralesional Corticosteroid Therapy for Childhood Cutaneous Hemangiomas

Cited by 40 publications

References 0 publications

Diagnosis and Management of Infantile Hemangioma

Diagnosis and Management of Infantile Hemangioma

Long Term Follow-up of Intralesional Laser Photocoagulation (ILP) for Hemangioma Patients

In vitro and in vivo photosensitizing capabilities of 5-ALA versus Photofrin� in vascular endothelial cells

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