title: Response of ulcerated perineal hemangiomas of infancy to becaplermin gel, a recombinant human platelet-derived growth factor.
abstract: BACKGROUND
  Hemangiomas of infancy are the most common tumors of childhood, and ulceration is the most common complication. Many treatments have been used for hemangioma ulceration, although none are uniformly effective. A recent report described the successful use of 0.01% becaplermin gel, a recombinant human platelet-derived growth factor, for an ulcerated hemangioma refractory to standard care. We sought to further assess the responsiveness of hemangioma ulceration to 0.01% becaplermin gel and to compare its cost to that of conventional modalities.
  
  
  METHODS
  We report a case series of 8 infants treated with becaplermin gel for ulcerated perineal hemangiomas of infancy. All infants were seen between January and June 2003 in the pediatric dermatology clinic at Texas Children's Hospital. Six female and 2 male infants were included. All of the hemangiomas were large (> or =6 cm(2)), and of superficial or mixed superficial and deep morphology. Rapid ulcer healing occurred in all patients within 3 to 21 days (average, 10.25 days).
  
  
  CONCLUSIONS
  In this small series, 0.01% becaplermin gel was a safe and effective treatment for perineal hemangioma ulceration. The rapid healing achieved with 0.01% becaplermin gel allows a reduction in the risk of secondary infection, pain, and need for hospitalization, as well as in the costs that often accumulate from multiple follow-up visits and long-term therapy.
authors.affiliation: Department of Dermatology, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin Street, Houston, TX 77030, USA.
authors.forename: Brandie J
authors.initials: BJ
authors.lastname: Metz
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Rubenstein
authors.forename: Moise L
authors.initials: ML
authors.lastname: Levy
authors.forename: Denise W
authors.initials: DW
authors.lastname: Metry
mesh_terms: D000279:Administration, Cutaneous; D000077214:Becaplermin; D005260:Female; D005782:Gels; D006391:Hemangioma / Q000151:congenital / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D010502:Perineum; D010982:Platelet-Derived Growth Factor / Q000008:administration & dosage*; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins / Q000008:administration & dosage*; D012878:Skin Neoplasms / Q000151:congenital / Q000188:drug therapy* / Q000473:pathology; D012883:Skin Ulcer / Q000151:congenital / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D005782:Gels; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; D000077214:Becaplermin