Management of infantile periorbital hemangiomas: a revisit

Abstract

Background Although infantile hemangioma is a common benign childhood tumor, it is still one of the challenging problems. Aim The current prospective study aimed to evaluate the effect of local propranolol gel in the treatment of infantile periorbital hemangioma. Patients and methods A prospective study in the period of 4 years from January 2012 to December 2016 was carried out on infants with periorbital hemangioma with a follow-up period of a minimum of 1 year. All infants underwent a fine-needle histopathological sample. All patients who proved to be capillary hemangioma were divided into two groups. Group I included those patients who were treated with topical timolol maleate gel from 4 to 30 weeks. On the other hand, group II included those patients who underwent a local corticosteroid therapy in the form of clobetasol 0.05% gel for a similar period. Posttherapy clinical and histopathological assessment took place in both groups. The obtained data were statistically analyzed. Results Twenty-eight patients were enrolled in the study. They were 18 women and 10 men with the ratio of women to men being about 2 : 1. In 21 infants, the tumor shrank in a period of 4–10 weeks after topical timolol administration. On the other hand, those who underwent local corticosteroid therapy showed a longer period for the shrinkage of the tumor; the P value is less than 0.003. Conclusion Local timolol gel therapy is superior to topical corticosteroid therapy with a wide range of safety and less side effects. Moreover, its cost-effectiveness is acceptable compared with other modalities such as laser therapy. The number of the study materials are limited; yet, it may be an indicator for a road map of managing infantile periorbital hemangiomas. Further studies with a larger population may be needed, as the problem deserves a full citizenship in the world of pediatric research.