Laser Treatment of Uncomplicated Hemangiomas Offers No Benefit Over Observation

Abstract

Dermatology| November 01 2002 Laser Treatment of Uncomplicated Hemangiomas Offers No Benefit Over Observation AAP Grand Rounds (2002) 8 (5): 57–58. https://doi.org/10.1542/gr.8-5-57-a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Laser Treatment of Uncomplicated Hemangiomas Offers No Benefit Over Observation. AAP Grand Rounds November 2002; 8 (5): 57–58. https://doi.org/10.1542/gr.8-5-57-a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: hemangioma, laser therapy Source: Batta K, Goodyear HM, Moss C, et al. Randomised controlled study of early pulsed dye laser treatment of uncomplicated haemangiomas: results of a 1-year analysis. Lancet. 2002;360:521–527. To evaluate the effect of pulsed dye laser (PDL) therapy on hemangiomas, these investigators from Birmingham and Nottingham, England, randomly assigned infants 1–14 weeks of age with early superficial hemangiomas to PDL treatment or observation. Randomization was stratified by whether a lesion was flat or raised; for those with multiple hemangiomas, the lesion causing greatest concern to the parents was selected for study. Infants whose hemangiomas had mixed or deep components, were located on the eyelid or were large and located on the face, or obstructed vital structures were excluded. Demographic information and the location, height, and surface area of the lesion were recorded at baseline. Infants in the PDL group were treated every 2 to 4 weeks depending on the rapidity of proliferation, and treatment continued until the lesion had cleared, stopped proliferating, stopped responding, or the parents requested no further therapy. All subjects were followed for hemangioma evaluation at 3, 6, 9, and 12 months after entry into the study. Any hemangioma that became problematic (eg, infected, obstructing vital structures, etc.) was treated appropriately, regardless of randomization group. The primary outcome measures assessed at 1 year included complications, adverse reactions, the proportion of lesions that had cleared completely or nearly completely (eg, were not palpable but had minimal residual erythema), and the proportion of parents who felt the hemangioma was still a problem. Secondary outcome measures included the surface area, height and redness of the lesion, and the opinion of an independent panel of parents about whether the remaining lesion posed a problem. Although the investigators planned to enroll 200 infants, recruitment was halted due to the observation that a substantial number of hemangiomas failed to respond to PDL and that scarring occurred in some patients. Of the 121 infants enrolled, 61 were assigned to observation and 60 to PDL treatment. Fifty-seven infants in the PDL group received a mean of 3 treatments; 8 discontinued therapy after a mean of 1 treatment. Three infants in the observation group required PDL therapy due to rapid growth or ulceration of their hemangioma. At 1 year, the percent of infants demonstrating complete or nearly complete clearance was similar among treated and observed infants (42% versus 40%, P = .92). Complete clearing, however, was more likely in those who were treated (30% versus 5%, P = .001). No significant differences between groups were observed in the percent of parents who considered that their infant’s hemangioma posed a problem (18% versus 15%), or the opinion of the independent panel of parents who thought that the hemangioma constituted a problem (30% versus 35%). Although treated hemangiomas were less likely to exhibit residual erythema, treated and untreated lesions did not differ significantly in height or surface area. Treated lesions had a smaller increase in surface area growth (38 mm2 versus 83... You do not currently have access to this content.