Reconstruction of Severe Nasal Deformity Following an Infantile Hemangioma

Abstract

We report the case of a 23-day-old neonate who presented at our center with a history of an erythematous lesion on the nose immediately after birth. The infant was born at a gestational age of 40 weeks and 2 days, with a body weight of 3,062 g. On initial examination, the erythema extended from the dorsum of the nose to the columella and ala (Fig. 1A). On the same day, the erythema was irradiated with a variable-pulse-width dye laser (Vbeam ® , Syneron Candela, Tokyo, Japan) with a pulse width of 20 msec and irradiation energy density of 11 J/cm 2 . However, this approach was ineffective. One week later, no ulceration was observed as a complication of the laser treatment. At 6 weeks of age, the hemangioma protruded and small ulcers developed in the right ala, which deformed the right nostril (Fig. 1B). Subsequently, the ulcers expanded; hence, the administration of propranolol (2 mg/kg/day) was initiated 9 weeks after birth. The ulcer healed 3 weeks after