Abstract
The therapeutic options for infantile hemangiomas (IHs) have been greatly altered since the introduction of oral propranolol for successful treatments of IHs. Recently, there is an increase in the application of topical timolol maleate for treating superficial IHs. In the present study, we developed a new formulation of timolol maleate 0.5% hydrogel and treated 321 patients with superficial IHs to evaluate its efficacy and safety in the treatment of superficial IHs. This new timolol hydrogel was applied three times daily with a mean duration of 7.1 months. Response to treatment was assessed according to cosmetic improvement by using visual analog scale (VAS). The average VAS improvement after treatment was 76.4, with 126 patients (39.3%) achieving excellent responses, 159 patients (49.5%) achieving good responses, 33 patients (10.3%) achieving fair responses, and three patients (0.9%) achieving poor responses. Age at treatment initiation (P = 0.0349) and lesion thickness (P = 0.0147) were significantly associated with therapeutic efficacy. No severe side effects were observed in all patients. In conclusion, this new topical timolol maleate 0.5% hydrogel appears to be a proper candidate for treating superficial IHs, and our study provides supportive evidence and experience of topical timolol maleate in treating superficial IHs.
Highlights
Infantile hemangiomas (IHs) are the most frequently occurring pediatric lesions, which are benign vascular tumors with a characteristic growth pattern of rapid proliferation and slow regression over several years [1]
Infantile hemangiomas are classified into superficial, deep, and compound types according to lesion distribution and anatomic depth of involvement [18]
We developed a new formulation of timolol maleate 0.5% hydrogel
Summary
Infantile hemangiomas (IHs) are the most frequently occurring pediatric lesions, which are benign vascular tumors with a characteristic growth pattern of rapid proliferation and slow regression over several years [1]. Data from present publications indicates that decreasing gestational age, low birth weight, and a female predominance are closely associated with higher IH incidence [2]. The decision on the initiation of IH treatment has been controversial in the past years due to the unique growth pattern of IHs. recent studies showed that most untreated IHs did not improve after 3.5 years of age [3], and more than 50% of untreated IHs exhibited significant residual lesions [4, 5]. Early and active intervention instead of “wait and see” policy might be a better strategy for the treatment of IHs.
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