Treatment Of Ulcerated Hemangiomas Research Articles

Medical, Surgical, and Wound Care Management of Ulcerated Infantile Hemangiomas: A Systematic Review [Formula: see text

Ulcerated infantile hemangiomas may present a therapeutic challenge, especially if there is concurrent hemorrhage or infection. The aim of this study was to systematically review the published evidence on the treatment of ulcerated hemangiomas, focusing on wound healing as the outcome of interest. We searched MEDLINE, Embase, SCOPUS, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science from inception to July 2016. Seventy-seven studies met our inclusion criteria. One study was a randomized controlled trial, 30 were observational studies, and 46 were case reports or case series. There is significant heterogeneity among the methods used. We reviewed 1239 patients in total. Of the 197 treated with oral propranolol, 191 (97.0%) achieved complete ulcer healing. Thirty-one patients failed corticosteroid therapy (oral, intralesional, or topical) and were subsequently successfully treated with other therapies. Surgical resections were typically performed for larger hemangiomas and those causing complications. None of the therapies discussed appear to offer significant advantages over others. Therefore, treatment decisions should be individualized based on location of disease, extent, symptoms, feasibility, cost, and parental preference.

Propranolol for infantile haemangiomas: experience from a tertiary center.

Aim:Infantile haemangiomas are the most common tumor of infancy. We report the use of propranolol for treatment of problematic and complicated haemangiomas.Patients and Methods:Propranolol was given to 52 children with mean age of 18.2 months at onset of treatment. After clinical and electrocardiographic evaluations, propranolol was administered with a starting dose of 2 mg/kg per day, given in 3 divided doses. Monthly follow up was done, response to oral propranolol therapy and any complications of therapy were recorded. Response to propranolol was classified as Complete Response, Excellent Response, Partial Response and Non Responder.Results:Total 49 patients showed significant improvement after propranolol therapy out of which 4 patients were complete responder, 30 patients (56.7%) were excellent responders; 15 patients (28.8%) were partial responders. 3 patients (5.7%) had growth of haemangiomas despite propranolol therapy and were classified as non-responder. Side effect like hypotension, rashes, gastroesophageal reflux was reported by 3 patients. In our study mean duration of treatment was 6.5 months. At the end of treatment propranolol was stopped by with gradual tapering of dose over a period of 2 weeks.Conclusion:Propranolol administered orally at 2 mg/kg per day has rapid effective therapeutic effect in treatment of ulcerated haemangiomas and it appears to be a valuable and effective treatment option for infantile haemangiomas beyond the proliferative phase, and esthetically disfiguring haemangiomas.

Treatment of ulcerated hemangiomas with propranolol: an evidence-based case report

Hemangiomas are the most frequent vasculartumors observed in early childhood. Thepresentation is unique, with an initialphase of proliferation, followed by aphase of slow, spontaneous regression after the age of1 year.1,2 Most hemangiomas are uncomplicated anddo not require intervention. However, therapy may beneeded if the hemangioma is located at certain bodysites, such as the face, or if it results in a functionalhandicap, such as limitation of eye opening. Inaddition, ulcerated, rapidly growing hemangiomasmay require treatment.3

Treatment of ulcerated hemangiomas with propranolol: an evidence-based case report

Treatment of ulcerated hemangiomas with propranolol: an evidence-based case report

Laser use in infantile hemangiomas, when and how

Infantile hemangiomas (IHs) are proliferating embrional tumors which can stem from placented tissue and are constituted by endothelial cell hyperproliferation. The management of the IHs is always challenging for all the specialists because of the heterogeneous behavior of these lesions. The factors leading to an aggressive position are essentially these: the prevention or reduction of aesthetic risks, the prevention or treatment of ulcerated hemangiomas, the prevention or impairment of functional risks and pain, and the removal of life-threatening risks. The treatment of vascular lesions is one of the mostly sought and performed cutaneous laser procedures, and in the field of IH treatments the more used laser devices certainly are pulsed dye lasers. Early laser therapy is able to reduce the possibility that the lesion will reach its full size, preventing several complications, connected to the hemangioma's growth, and providing psychological relief for pediatric patients and their parents.

Treatment of Ulcerated Hemangiomas in Infancy

Ulceration of hemangiomas occurs in up to 5% or 10% of all infants with lesions.1Ulcerated hemangiomas are quite painful and place the infant at risk for secondary bacterial infection. The pain is often severe enough to prevent an infant from sitting and being held. Many infants with ulcerated hemangio mas in the diaper area will cry with each urination, bowel movement, and diaper change. Ulcerated hemangiomas located on the lip can cause difficulty with feeding. Treatment of ulcerated hemangiomas can be difficult and prolonged. Standard treatment in the past has included local wound care, antibiotics, and/or intralesional or systemic steroids. The mechanism of ulcer formation is unknown, but the ulcers are thought to develop during the rapid growth phase in mixed superficial and deep hemangiomas. The most common locations for ulcerations to occur have not previously been defined. In a preliminary report,2we have previously described the use of the pulsed

Treatment of Ulcerated Hemangiomas With the Pulsed Tunable Dye Laser

Hemangiomas are the most common tumor of infancy and are characterized by rapid growth during the first 6 months of life. During the rapid growth phase, approximately 5% to 10% of the hemangiomas ulcerate. Ulcerated lesions are painful, may bleed, and are at risk for bacterial infection. Previous therapy has included daily local wound care, topical antibiotics, and local and systemic steroids. We treated nine infants (eight female and one male) with ulcerated hemangiomas by means of a vascular-specific (585-nm) pulsed (450-microsecond) tunable dye laser. Eight of the nine patients had a single ulceration, whereas one patient had two ulcerations within a large hemangioma. Six of the ulcerations healed with a single laser treatment. One ulceration required two treatments to heal, and the remaining two required three treatments. Pain was subjectively decreased within 2 to 3 days in all patients after a single treatment. The pulsed tunable dye laser should be considered in the treatment of all ulcerated hemangiomas.