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Journal of the Dermatology Nurses' Association

August 2010, Volume 2 Number 4 , p 177 - 179


  • Allison Sutton


Manunza F, Syed S, Laguda B, Linward J, Kennedy H, Gholam K, et al. (2010). Propranolol for complicated infantile haemangiomas: A case series of 30 infants. British Journal of Dermatology, 162, 466-468.Infantile hemangiomas are benign proliferations of blood vessels. They are the most common tumor of infancy. The natural history of this benign tumor consists of a proliferative phase lasting several months followed by involution. Most untreated hemangiomas resolve by 7 to 9 years of age, if not earlier. Most hemangiomas require little or no treatment intervention; however, certain hemangiomas can be problematic because of their size, location, or propensity to ulcerate. For hemangiomas that require treatment, the mainstay of therapy until recently has consisted of high-dose, long-term, systemic corticosteroids. Although this therapy is often successful in the treatment of hemangiomas, it has the potential for significant adverse effects. Recently, propranolol, a nonselective beta-blocker, has been used successfully in the treatment of complicated infantile hemangiomas.In this case series, 30 infants were identified with infantile hemangiomas complicated by visual compromise, partial nasal obstruction, subglottic location with potential for airway compromise, ulceration, or large size on the face. All patients were treated with propranolol. Nine infants had an inadequate previous response to systemic corticosteroids. Two infants were started on propranolol and prednisolone at the same time.Propranolol was given at an initial dose of 1 mg/kg/day divided into three doses, and this dose was increased after 1 week to 2 mg/kg/day. The infants were seen every 4 weeks, and the dose of propranolol was adjusted on the basis of their current weight. Nineteen infants were treated for a period of 3.5 to 15 months, and 11 had ongoing treatment over 5 to 15 months.All of the hemangiomas stopped growing and became paler and softer. In 26 of 30 infants, the response was noted within

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