Topical timolol versus oral propranolol for the treatment of hemangioma in children

Abstract

Objective To evaluate the clinical efficacy and adverse effects of oral propranolol in comparison with topical timolol for the treatment of hemangioma. BackgroundPrevious research declares that hemangioma is the most common tumor of infancy and childhood, occurring in 4–10% of white infants.Patients and methodsTo reach the goal of this research, a prospective randomized study was performed by selecting 20 patients with hemangioma attending the Pediatric Surgery Clinic at Menoufia Main University Hospital and Damanhur National Medical Institute. All patients were subjected to detailed history taking, clinical examination, echocardiogram, complete blood picture, liver and kidney functions, and blood glucose level. Determination of the location and dimensions of hemangioma was based on direct measurement and photographic analysis. Doppler ultrasound was used for baseline data regarding site, size, depth, vascularity, and flow.ResultsThere was a statistically significant difference regarding dimensions of the lesion (mm) when comparing propranolol patients before treatment and after treatment (P = 0.010) and also when comparing timolol patients before treatment and after treatment (P = 0.008). There was a statistically significant difference regarding to dimensions of the lesion (mm) by ultrasound when comparing propranolol patients before treatment and after treatment (P = 0.003) and also, when comparing timolol patients before treatment and after treatment (P = 0.008).ConclusionOur study reveals that both systemic and topical beta-blockers can be used effectively for treatment of hemangioma; however, much better improvements were obtained on using systemic propranolol than topical timolol. Topical timolol can be used as a first-line treatment for superficial infantile hemangiomas.