Management of infantile haemangioma

Abstract

Infantile haemangiomas (IH) are common benign vascular neoplasms of infancy. Natural history follows a characteristic pattern - proliferation, stabilisation, and involution. Most IH remain uncomplicated. Watchful expectancy will suffice for this group. Segmental type of IH over face and lower back can be associated with extra cutaneous abnormalities. A small subset of IH gets complicated with risk of functional impairment, cosmetic disfigurement, or ulceration. Systemic treatment is required for this selective group to hasten natural involution and prevent secondary complications. Oral propranolol has revolutionised the management of IH and is now the first line systemic treatment. Topical beta blockers have also been used increasingly in the management of superficial localised lesions. Other systemic options include oral steroids, vincristine, interferon but all of these have a limited role due to adverse side effects. A multidisciplinary approach with the team of paediatricians, paediatric dermatologists and other specialists is essential in management of complicated IH.