Treatment Of Hemangiomas Research Articles

POSTER ABSTRACTSP01 Our experience with outpatient initiation of propranolol in the treatment of complicated infantile haemangiomas

Abstract During the COVID-19 pandemic, consensus expert opinion published guidelines on the outpatient initiation of propranolol in the treatment of complicated infantile haemangiomas (IH). We performed an audit from 2015 to 2019 which demonstrated that the establishment of a dedicated IH clinic both improved access to and resulted in earlier initiation of propranolol in the Mid-West region. The aims of this re-audit were to evaluate patients referred to our clinic with IH, and to assess our compliance with international guidelines on the use of propranolol for the treatment of IH. All patients commenced on propranolol following referral to our dedicated IH clinic from January 2019 to September 2021 were identified from our dermatology database, and clinical and demographic data were collected from their charts. Data analysis demonstrated a 21-fold increase in outpatient initiation of propranolol, with 57% (n = 16/28) of patients commencing treatment as outpatients. In those patients who received inpatient initiation of propranolol, inpatient initiation was indicated in 88% (n = 8/9). We report treatment of 28 patients over 2 years with IH, 16 of whom were safely initiated in the outpatient setting, consistent with updated international guidelines. The main focus should now be on primary care education about IH in our community to ensure early intervention with propranolol when indicated.

Results of surgical treatment of patients with hemangiomas of the thoracic and lumbar vertebrae

The main goal of the study was to determine the effectiveness of surgical treatment of solitary and multiple hemangiomas within the vertebral body of the thoracic and lumbar spine.

Experience of surgical treatment of hemangioma of the spleen. A clinical case

Focal mass lesions of the spleen are considered rare. The mass lesions of the spleen usually include malignant and benign tumors, true, false, and parasitic cysts, abscesses, hematomas, and spleen infarctions. Hemangiomas are considered the most common benign neoplasms. Abscesses or spleen infarctions have severe symptoms, pronounced laboratory test changes, disturb the patient and force him to seek help. In contrast, small benign and sometimes malignant neoplasms are asymptomatic for a long time and often are incidental findings. A 38-year-old patient with splenomegaly was admitted to the thoracic surgery center of the Private healthcare institution, Central Clinical Hospital "RZD-Medicine". Abdominal computed tomography showed an enlarged spleen. The blood tests were within the reference values. Given the large size of the spleen, the need to exclude marginal zone lymphoma, clinical presentation, and the risk of spleen rupture, a splenectomy was performed.

Current status and update of infantile hemangioma in diagnosis and therapy

Infantile hemangiomas (IHs) are benign vascular tumors commonly observed in children. It is important to familiar with the characteristic features of hemangioma before diagnosis. Lesions located special position including periorbital and beard region, segmental hemangioma related PHACE syndrome and LUMBAR syndrome, hepatic hemangioma and related possible risks should be recognized. Early evaluation and assessment of risk grades should be done as early as possible before proliferation phase, so as to choosing the optimal treatment opportunity and scheme. β-blockers are the mainstay of therapy for moderate-to-high risk hemangiomas nowadays. Early initiation of treatment can prevent adverse complications and achieve the best outcome. During the diagnosis and treatment of infantile hemangioma, it emphasizes updating of the concept of naming and classification, treatment timing control and therapeutic scheme selection. Standardized clinical diagnosis and treatment should be promoted currently.

Combinative effects of β-elemene and propranolol on the proliferation, migration, and angiogenesis of hemangioma.

Hemangioma (HA) is one of the most common benign vascular tumors among children. Propranolol is used as the first-line treatment for hemangioma and is a non-selective blocker of the β-adrenergic receptor. β-elemene is a compound extracted from Rhizoma zedoariae and has been approved for the treatment of tumors in clinical practice. However, the combinatorial effects of β-elemene and propranolol in the treatment of HA remains unclear. This study explored the combinative effects and mechanisms of β-elemene and propranolol using hemangioma-derived endothelial cells (HemECs). Cytotoxic assays showed that the combinatorial treatment of β-elemene and propranolol did not increase the cytotoxic effects of HemECs. Furthermore, functional analysis showed that the combinatorial treatment with β-elemene and propranolol significantly inhibited the proliferation, migration, and tube formation of the HemECs compared to the single treatment regimens. Mechanistic analysis showed that combinative treatment with β-elemene and propranolol synergistically down-regulated the hypoxia-inducible factor-1 alpha/vascular endothelial growth factor-A (HIF-1-α/VEGFA) signaling pathway. Additionally, in a xenograft tumor model, angiogenesis in the combinatorial treatment group was significantly lower than in the control, propranolol, and β-elemene treatment alone groups. Our results suggest that β-elemene combined with propranolol can significantly inhibit the proliferation, migration, and tube formation of HemECs via synergistically down-regulating the HIF-1-α/VEGFA signaling pathway without increasing any cytotoxic side effects.

Foam Sclerotherapy in the Treatment of Hemangiomas and Venous Malformations.

Sclerotherapy has achieved great success in treating most venous malformation (VM) lesions. To compare the effects of foam sclerotherapy on infantile hemangioma and pyogenic granuloma (PG). In addition, we analyzed the data and outcomes of foam sclerotherapy for the VM. Thirty-nine patients with hemangiomas and 83 patients with VMs were treated, and clinical outcomes, resolution, and complication rates were compared. Sclerotherapy data from the VM group were also analyzed. The average age of the patients and the distribution and tissue involvement of lesions among the 3 groups were significantly different ( p < .001). The average amount of sclerosing foam administered per session in VMs was significantly higher than that in the other 2 groups ( p < .0001) (whereas that in the PG group was lower than that in the infantile hemangioma group [ p < .0001]). However, the overall therapeutic efficacy and side effects in the 3 groups were not significantly different. For VMs, the frequency of ultrasound guided foam sclerotherapy and use of 3% polidocanol increased from superficial to deep lesions, whereas the use of 1% POL decreased ( p < .0001). Infantile hemangioma and PG treatments presented good results and minor adverse reactions comparable with those of VMs.

Propranolol, Promising Chemosensitizer and Candidate for the Combined Therapy through Disruption of Tumor Microenvironment Homeostasis by Decreasing the Level of Carbonic Anhydrase IX

Resistance to chemotherapy represents a persisting medical problem, ranking among main causes of chemotherapy failure and cancer mortality. There is a possibility to utilize and repurpose already existing therapeutics which were not primarily intended for oncological treatment. Overactivation of adrenergic receptors and signaling dysregulation promotes tumor progression, metastatic potential, immune system evasion, tumor angiogenesis and drug resistance. The non-selective beta-blocker propranolol, approved in infantile haemangioma treatment, has a high potential for use in cancer therapy. We analyzed the effects of propranolol and 5-fluorouracil combination on sensitive and resistant cells derived from colorectal carcinoma in monolayers, single-component and co-culture spheroids and in vivo mouse models. Our results revealed that propranolol is able to exert its effect not only in chemosensitive colorectal cells, but also in 5-fluorouracil resistant cells. Propranolol disrupts the hypoxic adaptation machinery by inhibiting HIF1α, carbonic anhydrase IX, and activates apoptosis, which may be important in the management of chemo-resistant patients. We showed that propranolol slows down the growth of xenografts formed from colorectal cancer cells, even from cells already adapted to the β-blocker. We provide clear evidence that blockade of β-adrenergic receptors affects essential signaling pathways modulating tumor microenvironment and thus the response to anticancer therapy. Our findings indicate that propranolol could be repurposed to serve as chemosensitizer in combined therapy aimed at disrupting homeostasis of tumor microenvironment.

Intraoral Hemangioma: An Overview of the Recent Advances

Hemangiomas are common tumors that exhibit a rapid increase in the number of blood vessels when analyzed microscopically. Hemangiomas are frequently seen since the birth of the infant and possibly enlarge with age. They most likely have developmental rather than malignant roots. Oral hemangiomas are still clinically relevant to the specialist dentist and will require proper clinical treatment regardless of their benign origin and behavior. Nowadays, physical examination, auxiliary inspection, and clinical history serve as the main pillars of diagnosis. Priority should be given in hemangioma treatment to functional harm brought on by the treatment, which may lead to a worsening of the patient’s current condition and may pose a threat to the patient’s life. This shows that early diagnosis, identification, and referral to specialists are critical steps in reducing associated problems and improving prognosis. Surgery and other forms of treatment have a greater rate of morbidity, recurrence, and complications and are not always effective. Oral propranolol is still a widely used first-line medication. Oral propranolol is still a widely used first-line medication, nevertheless. Together with a review of related literature, the main focus of this study will be on the recent changes and modifications being made to ensure accurate diagnosis.

Illustrative resection of mixed intra- and extramedullary thoracic spinal cord capillary hemangioma.

Capillary hemangiomas are typically superficial benign tumors of the cutaneous and mucosal tissues of the face and neck in pediatric patients. In adults, they typically occur in middle-aged males who present with pain, myelopathy, radiculopathy, paresthesias, and bowel/bladder dysfunction. The optimal treatment for intramedullary spinal cord capillary hemangiomas is gross total/en bloc resection. Here, we present a 63-year-old male with increasing right greater than left lower extremity numbness/ weakness, attributed to a T8-9 mixed intra- and extramedullary capillary hemangioma. One year following complete lesion resection, the patient used an assistive device to ambulate and continued to improve neurologically. We presented a 63-year-old male whose paraparesis was attributed to a T8-9 mixed intra- and extramedullary capillary hemangioma who did well following total en bloc lesion resection. In addition to this case study/technical note, we provide a 2-D intraoperative video detailing the resection technique.

Predictors of poor response to oral propranolol in infantile hemangiomas

BackgroundPropranolol is the first-line treatment for infantile hemangiomas (IH). Cases of propranolol-resistant infantile hemangiomas are rarely reported. The purpose of our study was to investigate the predictive factors for poor response to propranolol. MethodsA prospective analytical study was conducted between January 2014 and January 2022 including all patients with IH who received oral propranolol therapy at a dose of 2–3 mg/kg/day maintained for at least 6 months. ResultsA total of 135 patients with IH were treated with oral propranolol. Poor response was reported in 18 (13.4%) of the patients: 72% were girls and 28% were boys. Overall, 84% of the IH were mixed, and hemangiomas were multiple in three cases (16%), nasal tip hemangiomas accounted for four cases (22%), and 15 patients (83%) had segmental hemangiomas. There was no significant association between the age or sex of the children and type of response to treatment (p > 0.05). No significant association was found between the type of hemangioma and the therapeutic outcome as well as the recurrence after treatment discontinuation (p > 0.05). Multivariate logistic regression analysis revealed that nasal tip hemangiomas, multiple hemangiomas, and segmental hemangiomas were at greater risk of poor response to beta-blockers (p < 0.05). ConclusionPoor response to propranolol therapy has rarely been reported in the literature. In our series, it was approximately 13.4%. To our knowledge, no previous publications have focused on the predictive factors of poor response to beta-blockers. However, the reported risk factors for recurrence are discontinuation of treatment before 12 months of age, mixed or deep type IH, and female gender. In our study, the predictive factors for poor response were multiple type IH, segmental type IH, and location on the nasal tip.

Rare case of vertebral hemangioma causing spinal compression - diagnosis and treatment: Space Occupying Lesion (SOL) study

Background. This case report highlights the importance of accurate diagnosis and treatment for intramedullary spinal cord hemangioma, which is a rare condition that can present with common symptoms of various spinal cord pathologies. The report recommends decompression laminectomy as the appropriate intervention for this condition. This report adds to the existing clinical literature on intramedullary spinal cord hemangioma and can assist clinicians in the diagnosis and treatment of similar cases. Case report. The patient is a 30-year-old female who complained of left leg heaviness, cramps, numbness, and urinary incontinence. MRI revealed a suspected intradural intramedullary lesion, as high as VTh5, suspected to be ependymoma or astrocytoma. The patient underwent decompressive laminectomy on thoracalis vertebra 5-7 and spinal cord mass with hemorrhage and calcification components was observed on post-operative Spinal CT Angiography. The mass was found to have a feeder artery from spinal branches of the left right a. intercostalis at T5 level and spinal branches of the left a. intercostalis at T6 level. Thoracolumbar spondylosis was also observed. Conclusion. The clinical impact of vertebral hemangioma lies in its potential to cause neurological deficits due to spinal cord or nerve root compression. Early diagnosis and treatment through imaging modalities such as MRI and surgical intervention, such as laminectomy, can alleviate symptoms and prevent disability or mortality. However, careful consideration of the patient’s clinical history, imaging findings, and neurological status is necessary for accurate diagnosis and appropriate management.

PA28 Case series of concomitant use of propranolol and prednisolone in the treatment of ulcerated infantile haemangiomas and an updated literature review

Abstract Infantile haemangiomas (IHs) are the most common benign tumours of infancy. Ten per cent of patients suffer complications, including ulceration, bleeding and functional impairment, and systemic treatment is required to reduce permanent disfigurement. Prednisolone was once the most commonly used and most efficacious treatment modality for complicated IHs, but propranolol has since overtaken its role as the first-line therapy in the last decade. In our practice, we have seen that propranolol monotherapy may not be sufficient in cases of IH with complex ulceration, and oral corticosteroids may serve as an effective adjunct in managing this group of patients. We present a case series of all patients diagnosed with ulcerated IH at KK Women’s and Children’s Hospital over the last 10 years. Fifteen patients were found to have ulcerated IHs. Eight patients were treated with both oral propranolol and oral prednisolone, and four patients were treated with oral propranolol alone. Patients were initiated on propranolol 1–2 mg kg−1 daily, and this dosage was titrated over an average of 9.6 months. Patients prescribed prednisolone had a tapering dosage starting from 0.5–2 mg kg−1 daily for 8–36 days. Average time to complete healing of ulcerated IHs in patients treated with both prednisolone and propranolol was 27.1 days, while patients treated with propranolol alone took 34 days. One patient had recurrence of ulceration after 2 months and had a second, 9-day course of prednisolone. None of the patients had complications from propranolol or prednisolone. Ulceration—the most common complication of IH—tends to heal poorly and is associated with pain, bleeding, infection and scarring. Early and efficacious treatment is needed to prevent functional impairment and permanent disfigurement. Several cases of ulcerated IH have been observed to be recalcitrant to propranolol monotherapy. In these patients, prednisolone used as an adjunct to propranolol has resulted in accelerated healing of these ulcerations. There are no guidelines on the dose and duration of prednisolone use, although a tapering dose starting at 1 mg kg−1 daily is usually given until complete healing of ulceration.

THE USE OF CRYOSURGERY IN THE TREATMENT OF EXTENSIVE LOWER LIP HEMANGIOMA

Hemangioma is a rapidly growing benign neoplasm that can cause both esthetic and functional impairment. It is relatively rare in the oral cavity and its most frequent site is the lower lip. Treatment mainly depends on the correct diagnosis and anatomical location. This report describes a clinical case of extensive lip hemangioma treated with cryosurgery. A 42-year-old Caucasian male presented a congenital hemangioma of the lower lip, which had been growing over the years. The patient was treated with 12 sessions of cryosurgery (5 cycles/session) with a significant reduction in the lesion. This minimally invasive approach is more comfortable and involves a lower risk of bleeding when compared to conventional surgery. In conclusion, cryosurgery is a viable option for the treatment of extensive hemangioma of the lip. Hemangioma is a rapidly growing benign neoplasm that can cause both esthetic and functional impairment. It is relatively rare in the oral cavity and its most frequent site is the lower lip. Treatment mainly depends on the correct diagnosis and anatomical location. This report describes a clinical case of extensive lip hemangioma treated with cryosurgery. A 42-year-old Caucasian male presented a congenital hemangioma of the lower lip, which had been growing over the years. The patient was treated with 12 sessions of cryosurgery (5 cycles/session) with a significant reduction in the lesion. This minimally invasive approach is more comfortable and involves a lower risk of bleeding when compared to conventional surgery. In conclusion, cryosurgery is a viable option for the treatment of extensive hemangioma of the lip.

Pediatric internal auditory canal cavernous hemangioma with rapid progression of sensorineural hearing loss: illustrative case.

Cavernous hemangioma of the internal auditory canal is extremely rare and is characterized by symptoms such as vertigo, sensorineural hearing loss, and facial nerve dysfunction. A health examination on an 11-year-old female in the fifth grade revealed hearing loss in the left ear. She also had dizziness that had persisted for approximately 1 year. Pure-tone audiometry revealed sensorineural hearing loss in her left ear. Rightward horizontal and rotatory nystagmus was detected. Facial paralysis was not present. Magnetic resonance imaging showed a lesion that was suspected to be hemangioma. The authors selected a left suboccipital retrosigmoid approach. The tumor showed a berry-tufted appearance throughout the cerebellopontine angle. The seventh cranial nerve penetrated the tumor and partly circulated outside the tumor with marked adhesion. The authors partially resected the tumor to avoid damaging the facial nerve. A histological examination identified cavernous hemangioma. The fundamental treatment for cavernous hemangioma of the internal auditory canal is complete surgical removal; however, any surgical intervention may result in hearing loss and facial paralysis. The extent of surgery needs to be decided intraoperatively based on the balance between preoperative symptoms and postoperative complications.

The proliferation and angiogenesis in hemangioma-derived endothelial cells is affected by STC2 medicated VEGFR2/Akt/eNOS pathway.

Stanniocalcin-2 (STC2), a secreted glycoprotein that is involved in the regulation of angiogenesis, was proposed as one of the mechanisms of neovascularization in hemangioma (HA). We aimed to investigate the effect of STC2 on proliferation and angiogenesis in hemangioma-derived endothelial cells. The hemangioma samples from HA patients with the median age of six months were surgically collected in the Affiliated Hospital of Weifang Medical University from October 2019 to June 2021, and divided into normal skin tissues (n=10), involuting-phase HAs (n=10) and proliferating-phase HAs (n=10) according to the Mulliken classification. The expression of STC2 was detected in involuting-phase HAs and proliferating-phase HAs. Hemangioma endothelial cells (HemEC) were transfected with small interfering RNA (siRNA) specific for STC2, and cell survival and tube formation were analyzed. STC2 expression in proliferating-phase HAs was markedly higher than in the normal skin tissues and involving-phase HAs. Similarly, STC2 expression was higher in HemEC compared to the control human umbilical vein endothelial cells (HUVEC). Knockdown of STC2 slowed the proliferation of HemEC and decreased the expression of proliferating cell nuclear antigen (PCNA) in HemEC. Moreover, knockdown of STC2 in HemEC inhibited vascular endothelial cell angiogenesis and regulated the expression and phosphorylation of vascular endothelial growth factor receptor 2 (VEGFR2). Mechanistically, STC2 knockdown attenuated the activation of Akt/eNOS signaling, which was abolished by insulin growth factor-1 (IGF-1), the activator of Akt signaling, accompanying by increased proliferation and tube formation of HemEC. Inhibition of STC2 suppresses HemEC proliferation and angiogenesis by VEGFR2/Akt/eNOS pathway, which warrants further development of STC2-based strategies for HA treatment.

Can Propranolol Affect Platelet Indices in Infantile Hemangioma?

Propranolol, a nonselective beta-blocker used in the medical treatment of infantile Hemangioma (IH), has been shown to decrease the levels of vascular endothelial growth factor and reduce angiogenesis with its antiproliferative and antiangiogenetic effects. It has been reported that the storage, transport, and secretion of vascular endothelial growth factor (VEGF) are associated with platelet volume indices (PVI). We aimed to investigate the effect of propranolol on PVI in IH patients. Propranolol treatment was started on 22 IH patients. Platelets, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit values in the follow-ups at months 0, 1, and 2 were compared between 22 patients who received treatment and 25 patients who did not. While a statistically significant difference between months 0, 1, and 2 in PDW and MPV values was detected in the treated group, it was not detected in the untreated group. Taking into consideration that VEGF levels were higher at the beginning of the treatment in the pathophysiology of the disease, it was thought that the decrease in VEGF levels by propranolol may have led to a decrease in MPV and PDW levels in the treatment group. Consequently, in IH cases, propranolol response follow-up can be evaluated with PVIs, especially MPV and PDW, and it may facilitate clinicians' monitoring of the disease after propranolol administration.

Risk factors analysis of surgical complications of hepatic hemangioma: a modified Clavien-Dindo classification-based study

PurposeThere are few studies on the risk factors of postoperative complications after surgical treatment of hepatic hemangioma (HH). This study aims to provide a more scientific reference for clinical treatment.MethodsThe clinical characteristics and operation data of HH patients undergoing surgical treatment in the First Affiliated Hospital of Air Force Medical University from January 2011 to December 2020 were retrospectively collected. All enrolled patients were divided into two groups based on the modified Clavien-Dindo classification: Major group (Grade II/III/IV/V) and Minor group (Grade I and no complications). Univariate and multivariate regression analysis was used to explore the risk factors for massive intraoperative blood loss (IBL) and postoperative Grade II and above complications.ResultsA total of 596 patients were enrolled, with a median age of 46.0 years (range, 22–75 years). Patients with Grade II/III/IV/V complications were included in the Major group (n = 119, 20%), and patients with Grade I and no complications were included in the Minor group (n = 477, 80%). The results of multivariate analysis of Grade II/III/IV/V complications showed that operative duration, IBL, and tumor size increased the risk of Grade II/III/IV/V complications. Conversely, serum creatinine (sCRE) decreased the risk. The results of multivariate analysis of IBL showed that tumor size, surgical method, and operative duration increased the risk of IBL.ConclusionsOperative duration, IBL, tumor size, and surgical method are independent risk factors that should be paid attention to in HH surgery. In addition, as an independent protective factor for HH surgery, sCRE should attract more attention from scholars.

ÇOCUKLUK ÇAĞI HEMANJİOMLARININ TEDAVİSİNDE TOPİKAL VE ORAL BETA-BLOKERLERİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Purpose: Hemangiomas are the most common vascular tumors of childhood, and the treatment options have undergone profound changes in recent years. We aimed to compare the effectiveness and safety of non-pharmacological treatment, topical beta blocker treatment, and and oral beta blocker treatment in the treatment of superficial and deep hemangiomas in the pediatric age group. &#x0D; Material and Methods: We retrospectively reviewed the medical records of pediatric patients with hemangioma. &#x0D; Results: Fifty-three patients (F/M=40/13) were enrolled in this study. Superficial hemangiomas were detected in 14 (26.4%) patients, and deep hemangiomas in 39 (73.6%). Seventeen patients were followed without medication, 19 patients were treated with a topical beta blocker , and 17 patients were treated with an oral beta blocker. Twelve patients with a superficial hemangioma were followed without medication while two patients received topical timolol treatment.&#x0D; A comparison of the lesion progress in the patients with superficial hemangiomas in non-pharmacological treatment and topical treatment groups, the mean scores of success in terms of mean fading and reduction in lesion depth were significantly higher at 1st month (7.0 vs 1.66; p=0.049; 6.0 vs 1.5; p=0.045). &#x0D; Among patients with deep hemangiomas, a comparison of mean fading scores showed no difference between the oral and topical treatment groups at both 1st and 4th month (p=0.551, p=0.551). &#x0D; Conclusion: We believe that topical treatment can replace oral beta blockers in the future, and will likely be more preferred by clinicians and families because of their fewer side effects.

Topical Application of 0.5% Timolol Maleate Hydrogel for the Treatment of Superficial Infantile Hemangiomas.

Oral propranolol is considered the first line therapy in the treatment of infantile hemangiomas (IHs). However, there are considerable side effects due to its ability to penetrate the blood brain barrier. Alternatively, topical timolol, a non-selective beta blocker, has resulted in fewer side effects and is 4&ndash;10 times more potent in comparison to oral propranolol. This study evaluates the efficacy of 0.5% timolol maleate hydrogel for the treatment of IH. This study was conducted via a quasi-experimental design from October 30, 2020 &ndash; April 29, 2021, at the Department of Dermatology Benazir Bhutto Hospital, Rawalpindi. 145 infants between 1&ndash;12 months in age diagnosed with superficial cutaneous hemangiomas were included in the study with a male to female ratio of 2.4:1. A thin layer of timolol maleate 0.5% hydrogel was applied to the entire surface of the patient&rsquo;s IH three times daily. Digital photographs and measurements of the hemangiomas were taken at one-month intervals for a maximum of 6 months. The age range in this study was from 1&ndash;12 months with a mean age of 6.10 &plusmn; 2.52 months. The majority of the patients 89 (61.4%) were between 1&ndash;6 months of age. Of the 145 patients, 89 (61.4%) showed an excellent response, 44 (30.3%) showed a good response, and 12 (8.3%) showed no response to the topical 0.5% timolol maleate hydrogel treatment. The use of topical 0.5% timolol maleate hydrogel is a promising therapeutic option for the treatment of superficial IHs. Anwar F, Mahmood E, Sharif S, et al. Topical application of 0.5% timolol maleate hydrogel for the treatment of superficial infantile hemangiomas. J Drugs Dermatol. 2023;22(6):594-598. doi:10.36849/JDD.7054.

Efficacy and Safety of Introduction Timolol Maleate by Manometer Microneedles among Infantile Hemangioma: A Retrospective Study in China.

The objective of the study was to compare the effective rate, cure rate, adverse reaction rate, and effective time of three methods in the treatment of infantile hemangioma, hoping to provide reference for improving the clinical therapeutic effect. This is a retrospective study of 307 infantile hemangioma patients admitted to the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, from January 2014 to October 2021. The patients were divided into three groups. In group A, timolol maleate solution was introduced by the nano-microneedle technique (97 cases); in group B, timolol maleate drops dipped in medical swabs were applied (107 cases); and group C patients took propranolol orally (103 cases). The effective rate, cure rate, adverse reaction rate, and effective time of treatment were recorded and compared. The total effective rate, total cure rate, and total adverse reaction rate of the three groups were 87.6, 65.2, and 9.4%, respectively. The results showed that the effective and cure rates of group A were higher than those of group B (92.8 and 76.3%, respectively; p < 0.05), the adverse reaction rate of group C was higher than that of group B (17.5%, p < 0.05), and the effective time of group A was shorter than that of groups B and C. In most patients, symptoms significantly improved within 2 months (p < 0.05). Timolol maleate introduced by nanometer microneedles is an effective and safe treatment for superficial hemangioma in infants with the highest effective and cure rates, lower incidence of adverse reactions, and the shortest effective treatment time.