Twenty years' experience of steroids in infantile hemangioma--a developing country's perspective.
BACKGROUND
Hemangioma is a common vascular tumor. Though it involutes spontaneously, results are unpredictable. Steroid therapy is an effective mode of its regression. We present our experience of largest series and possible recommendations for treatment.


METHODS
A total of 2398 patients were treated during the study period of 20 years. They were given oral prednisolone, intralesional triamcinolone, or combination of both as per the protocol and followed for the response. Response to the treatment was graded as excellent, good, poor, or no response.


RESULTS
The male-to-female ratio was 1:2.3. In 81% of patients, hemangioma was noticed within first month of life. The commonest site of involvement was head and neck (57%). The commonest clinical presentation was discoloration and swelling. Mean age and size were 8.43 +/- 7.04 months and 23.64 +/- 20.13 cm(2). Response rate was highest for superficial type using any modality of treatment. Patients younger than 1 year showed better response (90.3%) in comparison with children older than 1 year (80.8%). The specific complications occurring were infections in 249 (12.4%), cushingoid facies and growth delay in 62 (3.1%), and hypertension in 51 (2.5%) patients.


CONCLUSIONS
Steroid therapy either oral or intralesional as per the requirement is an easy and safe modality. Results are good to satisfactory in most patients. The complications are minimal. If treatment is needed, it should be used as a first-line therapy, especially when cost is an important concern.
Pandey
Anand
A
Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, UP, India.
Gangopadhyay
Ajay Narayan
AN
Gopal
Saroj Chooramani
SC
Kumar
Vijayendra
V
Sharma
Shiv Prasad
SP
Gupta
Dinesh Kumar
DK
Sinha
Chandrasen Kumar
CK
D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D015552:Injections, Intralesional; D008297:Male; D009367:Neoplasm Staging; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D013256:Steroids / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use
D013256:Steroids; D014221:Triamcinolone