Thirty‐two Japanese cases of infantile hemangiomas treated with oral propranolol

Abstract

Infantile hemangiomas undergo rapid growth during early infancy followed by gradual involution. Infantile hemangiomas sometimes impair vital functions or cause disfigurement. Thirty-two Japanese patients between the ages of 1 and 4 months with proliferating infantile hemangiomas received oral propranolol on an outpatient basis. The success rate (complete or nearly complete resolution) at week 25 was 56% (18/32). Two patients dropped out because of a personal reason and moving out. Recurrence after termination of treatment was seen in six patients. Adverse events occurred in 16 patients. There were no adverse events on day 1 (initiation of treatment at a dose of 1 mg/kg per day) and day 8 (dose increase to 2 mg/kg per day). One patient was hospitalized due to pneumonia, and suspended propranolol for 26 days. Oral propranolol at 2 mg/kg per day is effective and safe in Japanese patients with infantile hemangiomas.

Oral propranolol for infantile hemangiomas beyond the proliferative phase

“…Administration of propranolol was initiated at a dose of 1 mg/kg per day divided into three doses for 1 week, and then increased to 2 mg/kg per day divided into three doses. 6,7 After the oral propranolol treatment for 25 weeks, all of the treated patients exhibited earlier color fading than the untreated patients (Figs 1,2). IH of patients 1, 3, 4 and 5 reached nearly complete resolution at week 25.…”

“…Baseline screening by a pediatric cardiologist included blood pressure, heart rate, blood glucose, echocardiogram, electrocardiogram and chest X ray. Administration of propranolol was initiated at a dose of 1 mg/kg per day divided into three doses for 1 week, and then increased to 2 mg/kg per day divided into three doses …”

“…around the eye, nasal tip, mouth and ear). Oral propranolol usually induces earlier involution and redness reduction in proliferative IH . Proliferative IH is suitable for oral propranolol treatment because oral propranolol can stop growth of IH.…”

“…Oral propranolol usually induces earlier involution and redness reduction in proliferative IH. 6,7 Proliferative IH is suitable for oral propranolol treatment because oral propranolol can stop growth of IH. However, to evaluate the effectiveness of oral propranolol for IH beyond the proliferative phase is difficult because of spontaneous regression.…”

Risk factors of long‐term alopecia after pulsed‐dye laser treatment for infantile scalp hemangiomas: A retrospective study

“…Infantile hemangiomas (IH) are benign tumors constitutive of proliferative blood vessels and represent the most common vascular tumor in the neonatal age with an incidence of 4.5% 1 . Beta‐adrenergic blockers are now listed as the first‐line therapy for high‐risk IH lesions, but in clinical practices for superficial lesions, its utilization is largely limited mainly due to the anxieties raised from the parents that long‐term and daily administration in newborns may induce various adverse effects, such as sleep disturbance, diarrhea, and vomiting 2,3 . Furthermore, beta‐adrenergic blockers are potentially dangerous in children with asthma and cardiovascular diseases, 4 which has further restricted its application, especially in superficial IH lesions.…”