title: Oral prednisolone for infantile hemangioma: efficacy and safety using a standardized treatment protocol.
abstract: BACKGROUND
  The efficacy of oral corticosteroid therapy for problematic infantile hemangioma depends on dosage, duration of treatment, and definition of therapeutic response. The purpose of this study was to determine the efficacy and safety of oral corticosteroid therapy using a standardized treatment protocol.
  
  
  METHODS
  The study comprised 25 consecutive patients with infantile hemangioma managed with oral prednisolone between 2007 and 2010. All patients were given 3 mg/kg/day for 1 month, followed by a 0.5-ml taper every 2 to 4 weeks. Predictive variables were age at initiation of treatment, sex, location, lesion size, and tumor depth. Treatment response was defined as no response, stabilization, or regression. Rebound growth and drug morbidity were recorded.
  
  
  RESULTS
  Tumors primarily affected the cheek (n = 12), orbit (n = 8), nose (n = 2), forehead (n = 2), or neck (n = 1). Treatment was initiated at an average age of 12.1 ± 7.2 weeks for 32.2 ± 10.0 weeks. All tumors responded to therapy; 88.0 percent (n = 22) regressed and 12.0 percent (n = 3) stabilized. Age at initiation of treatment, sex, location, lesion size, and tumor depth did not affect treatment response (p = 0.13). Rebound growth occurred in 8.0 percent of infants, and 20.0 percent demonstrated a transient cushingoid appearance. No patients suffered drug morbidity.
  
  
  CONCLUSIONS
  The administration of oral prednisolone using a standardized protocol of 3 mg/kg given once daily for 1 month, followed by a taper until the infant is 10 months of age, is an effective treatment for infantile hemangioma. Therapy is safe because it is limited to several months and the dosage is continually weaned as the infant gains weight.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Boston, Mass. From the Department of Plastic and Oral Surgery, Children's Hospital Boston, Harvard Medical School.
authors.forename: Arin K
authors.initials: AK
authors.lastname: Greene
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Couto
mesh_terms: D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005153:Facial Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D006391:Hemangioma / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011379:Prognosis; D019233:Retreatment; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone