Predictors of treatment responses of superficial infantile hemangiomas to topical timolol

Abstract

Topical timolol is not effective in the treatment of some superficial infantile hemangiomas (IHs). This is a prospective study aiming to investigate the predictors of treatment response of superficial IHs to topical timolol. Patients with superficial IHs were prescribed timolol 0.5% cream four times daily and followed up every 2-3 months until 1 year of age. IH thickness was objectively measured by ultrasound, and the proportional change was calculated as a regression rate. In total, 193 patients (211 lesions) were enrolled. Topical timolol was initiated at an average age of 3.1 (0-6) months for 7.4 (2-11) months. The average regression rate of all lesions was 41.8% (À137.5%-100%). Lesion thickness (p = 0.000) and patient age at initial treatment (p = 0.001) were major variables that predicted the treatment response. On average, an increase in lesion thickness of 1 mm decreased the regression rate by 22.1%, and lesions thicker than 1.9 mm were unlikely to respond (average regression rate = À0.27%). Available results did not show a significant effect of sex (p = 0.659), lesion size (p = 0.311), or location (p > 0.05) on regression. Treatment for superficial IHs should be individualized according to lesion thickness and patient age.

Clinical and morphological characteristics and diagnosis of external haemangiomas in children

“…The ultrasound findings of infantile haemangioma can clearly identify the vessels in or around the pathological focus, and solid calcinates or their fragments. H. Zheng et al [14] and C. Mazzini et al [15] note that classical haemangiomas proceed without degenerative changes. Rapid regression of congenital haemangiomas may be accompanied by transient thrombocytopenia and manifestations of coagulopathy.…”