Itraconazole Oral Solution for a Case of Infantile Hemangioma: Monitoring the Efficacy by Dermoscopy and MRI

Abstract

Infantile hemangioma is a common and challenging benign vascular tumor. Although involution is spontaneous, approximately 10% of infantile hemangioma of large size or in specific locations may cause ulceration, severe cosmetic and functional problems that may require intervention. Treatment options include oral propranolol, topical timolol, and oral corticosteroids. However, the clinical response is not always satisfactory. We report the case of a 4-month-old boy who presented with an irregular erythematous plaque on his left shoulder 3 days after birth. Infantile hemangioma was diagnosed. Topical application of 0.5 ml of 0.5% timolol maleate eye drops for half an hour each time three times a day was initiated. After nearly 3 months of follow-up, the size of the lesion gradually increased. Finally, after 115 days of treatment with itraconazole oral solution (the total dose was about 4025 mg), the refractory infantile hemangioma was successfully treated. Hepatic and renal function remained normal with only mild diarrhea during the course of oral medication. Treatment compliance of oral itraconazole in infants has been reported to be good. Dermoscopy and magnetic resonance imaging (MRI) played a crucial role in in vivo observation of the hemangioma changes with vascular regression during the treatment process.

Clinical Observation of MRI Image in Floating Needle Therapy for Cervical Spondylosis of Cervical Type

“…Based on the method of orthogonal transformation, this method mainly generates the observation matrix through the transformation of the orthogonal matrix. The specific steps are as follows: form an N × N -dimensional orthogonal matrix, then take M rows from the matrix to obtain an M × N -dimensional matrix, and finally, normalize the column direction of the matrix to obtain the observation matrix [ 19 , 20 ]. At present, the observation matrix obtained by this method is mainly composed of the partial Fourier observation matrix and partial Hadamard observation matrix.…”

Itraconazole Oral Solution for Infantile Complicated Hemangioma with Double Lesions on the Skin and One Inside the Liver

“… 29 , 30 In 2015, our team found that ICZ had a positive effect on the treatment of IH, which was further confirmed in later treatment practice. 13 , 14 Research also demonstrated that oral itraconazole can be an equivalent option for oral propranolol while safer and shorter treatment periods. 31 We found that ICZ can induce IH regression by downregulating the platelet-derived growth factor-D/PI3K/Akt/mTOR pathway.…”

“…Our team has previously reported cases in which ICZ was used in infants with hemangioma. 13 , 14 Herein, we report a case of infantile cutaneous hemangioma complicated with hepatic hemangioma treated by oral ICZ solution. Dermoscopy and color ultrasound images play a vital role in the diagnosis and in the therapeutic efficacy monitoring.…”