Propranolol for severe infantile hemangiomas: follow-up report.
OBJECTIVE
Infantile hemangiomas (IHs) are the most-common soft-tissue tumors of infancy. We report the use of propranolol to control the growth phase of IHs.


METHODS
Propranolol was given to 32 children (21 girls; mean age at onset of treatment: 4.2 months) after clinical and ultrasound evaluations. After electrocardiographic and echocardiographic evaluations, propranolol was administered with a starting dose of 2 to 3 mg/kg per day, given in 2 or 3 divided doses. Blood pressure and heart rate were monitored during the first 6 hours of treatment. In the absence of side effects, treatment was continued at home and the child was reevaluated after 10 days of treatment and then every month. Ultrasound measurements were performed after 60 days of treatment.


RESULTS
Immediate effects on color and growth were noted in all cases and were especially dramatic in cases of dyspnea, hemodynamic compromise, or palpebral occlusion. In ulcerated IHs, complete healing occurred in <2 months. Objective clinical and ultrasound evidence of longer-term regression was seen in 2 months. Systemic corticosteroid treatment could be stopped within a few weeks. Treatment was administered for a mean total duration of 6.1 months. Relapses were mild and responded to retreatment. Side effects were limited and mild. One patient discontinued treatment because of wheezing.


CONCLUSIONS
Propranolol administered orally at 2 to 3 mg/kg per day has a consistent, rapid, therapeutic effect, leading to considerable shortening of the natural course of IHs, with good clinical tolerance.
Sans
Véronique
V
National Reference Center for Rare Skin Diseases, Children's Hospital, Bordeaux, France.
de la Roque
Eric Dumas
ED
Berge
Jérôme
J
Grenier
Nicolas
N
Boralevi
Franck
F
Mazereeuw-Hautier
Juliette
J
Lipsker
Dan
D
Dupuis
Elisabeth
E
Ezzedine
Khaled
K
Vergnes
Pierre
P
Taïeb
Alain
A
Léauté-Labrèze
Christine
C
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D011433:Propranolol