Combination therapy of infantile hemangioma with pulsed dye laser with topical propranolol: a randomized clinical trial.

Abstract

The combination of pulsed dye laser (PDL) and topical propranolol are used with variable effectiveness for the treatment of infantile hemangiomas (IH), particularly for superficial lesions. The aim of this study was to investigate whether the therapeutic efficacy of prescribing topical propranolol along with PDL was superior to PDL therapy alone in the treatment of IH. A total of 19 patients with IH were recruited to the study. Among them, nine patients were treated with PDL, 3 sessions 4 weeks apart, and 10 patients underwent PDL treatment alongside with topical propranolol for 12 weeks. The therapeutic efficacies of each regimen were assessed by comparing photographs of skin lesions before and after the treatment based on the cessation of the lesion growth, reduction in the lesion size, and lightening of the lesion color. No side-effect was reported by the parents. Among nine patients in PDL group, only two (22%) had excellent clearance, one (11%) had good, three (30%) had weak, and three (30%) had no responses. On the other hand, among 10 patients who were treated with both the PDL and topical propranolol, five (50%) showed excellent responses and five (50%) displayed good responses. Statistical data analysis with Mann-Whitney test revealed a significant difference in the clinical response between two treatment groups. The combination of PDL and topical propranolol seem to be a safe and effective therapy, and results in better clinical responses in the treatment of IH than PDL therapy alone.