Treatment of infantile haemoangioma – Update 2016

Abstract

Summary Aim Complicated infantile hemangioma need early, safe and effective treatment. The aim of this study was to provide greater insight into systemic and topical propranolol treatment efficacy and side effects. Methods We report our retrospective experiences of 207 paediatric patients treated with systemic propranolol and of 148 paediatric patients treated with propranolol gel topically photographed and analysed with a specific hemangioma score. Results Propranolol treatment was successful in >99 % of the patients. The hemangioma score showed a significant decrease during systemic treatment (8.3 ± 3.3 at beginning and 1.5± 1.4 after 6 months) and during topical treatment (4.2 ± 1,6 at beginning and 2.2 ± 1.3 after three months). Systemic treatment did not show any differences when distributed according to different localizations or to the patient`s ages. During topical propranolol treatment relevant serum levels were not determined. Relevant side effects that may have made it necessary to discontinue the treatment were not observed. However, there was a statistically significant reduction in heart rate but not in mean arterial blood pressure during the first six in-hospital systemic drug applications. Conclusion Systemic propranolol treatment is highly effective and nearly always safe. Topical treatment with propranolol gel (off-label) is suitable for specific hemangioma in addition to cryotherapy and systemic treatment with propranolol. These findings provide highly valuable information on this drug treatment for complicated infantile hemangioma in infants.