title: Propranolol for severe infantile hemangiomas: follow-up report.
abstract: 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.
authors.affiliation: National Reference Center for Rare Skin Diseases, Children's Hospital, Bordeaux, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Sans
authors.forename: Eric Dumas
authors.initials: ED
authors.lastname: de la Roque
authors.forename: Jérôme
authors.initials: J
authors.lastname: Berge
authors.forename: Nicolas
authors.initials: N
authors.lastname: Grenier
authors.forename: Franck
authors.initials: F
authors.lastname: Boralevi
authors.forename: Juliette
authors.initials: J
authors.lastname: Mazereeuw-Hautier
authors.forename: Dan
authors.initials: D
authors.lastname: Lipsker
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Dupuis
authors.forename: Khaled
authors.initials: K
authors.lastname: Ezzedine
authors.forename: Pierre
authors.initials: P
authors.lastname: Vergnes
authors.forename: Alain
authors.initials: A
authors.lastname: Taïeb
authors.forename: Christine
authors.initials: C
authors.lastname: Léauté-Labrèze
mesh_terms: 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*
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol