Intralesional Corticosteroid Therapy for Infantile Hemangiomas

Diagnosis and Management of Infantile Hemangioma

“…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.…”

“…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.…”

“…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.…”

“…[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.…”

Terapi Vincristine dan Triamcinolone dalam pengobatan Hemangioma Infantil

“…Pilihan terapi pertama adalah dengan pemberian kortikosteroid secara sistemik, intralesi atau topikal. [6][7][8][9][10][11] Sebagai pilihan terapi kedua dapat diberikan interferon alpha-2a dan 2b, [12][13] Pemeriksaan fisik meliputi jumlah, letak anatomi, gejala berat lainnya seperti gangguan makan, komplikasi sistemik dan gangguan penglihatan sehingga seluruh pasien tidak dilakukan pemeriksaan lain untuk mencari keterlibatan hemangioma terhadap organ dalam tubuh. Jenis pengobatan tertera pada Gambar 1, 24 pasien diberikan terapi kortikosteroid dan 2 pasien dilakukan observasi.…”