Ultrapotent topical corticosteroid treatment of hemangiomas of infancy

Abstract

Superficial cutaneous hemangiomas of infancy represent a therapeutic challenge. Two small case series using ultrapotent topical corticosteroids for periocular hemangiomas were reported in the ophthalmologic literature. The use of this therapy for hemangiomas of infancy at other sites on the body has not been reported. We sought to assess the clinical effects of short-term application of ultrapotent topical corticosteroids for the treatment of hemangiomas of infancy. The records of 34 infants with proliferating hemangiomas of infancy that were treated with ultrapotent topical steroids were reviewed retrospectively. Treatment response was based on: (1) cessation of growth; (2) shrinkage or flattening of the lesion; and (3) lightening of the surface color. Lesions demonstrating responses of two of the three criteria were judged to have good response; one criterion, partial response; and no improvement, no response. Of the patients, 35% demonstrated good response, 38% partial response, and 27% no response. Hemangiomas in 74% of the infants demonstrated either good or partial response to treatment with ultrapotent topical corticosteroids. Of the responders, the majority reported cessation of growth before what would have been expected for their age. Improvement varied, with thinner superficial hemangiomas demonstrating better cosmetic improvement than thicker lesions.