Use of Propranolol in Infantile Hemangioma Resulting in Scarless Healing

Abstract

Infantile hemangiomas (IHs) are the most common childhood tumors. Some can ulcerate causing pain, bleeding, and scarring, leading to cosmetical disfigurement. The use of propranolol has beaten the traditional high-dose systemic corticosteroids therapy, which falls short on its infamous adverse effects. In these case series, regimen of propranolol was highlighted when surgery is not an option. Two cases were presented. Case 1 involveda threemonth-old baby girl was presented with a 0.6x0.6 cm disfiguring purple tumor on her nasal tip and columella and Case 2 involveda three-month-old baby girl with a 2x0.5 cm sharply bordered and bulging red tumor on her left labium major.Both lesions became visible at the age of 3 months and grew rapidly since then. Propranolol was initiated at 2 mg/kgBW per day with careful administration. Adverse effects and drug tolerance were closely monitored under pediatrician and plastic surgery care with none reported. Dramatic results was seen after 2 weeks of treatment and no scar was found at the end of the therapy. This confirmed that propranolol is an effective and well tolerated treatment when commenced early and continued with the minimum protocol of 2 mg/kgBW/ day through the proliferative phase of infantile hemangioma. It is concluded that propranolol is beneficial for managing infantile hemagioma cases with a scarless outcome that cannot be achieved through surgery. The use of propanolol is extremely beneficial when the case involves a tumor in a site that makes it impossible for reconstruction.