title: Current concepts in the management of periocular infantile (capillary) hemangioma.
abstract: OBJECTIVE
  To review and evaluate the medical literature on new treatments for periocular infantile (capillary) hemangioma. Recent studies have shown a promising new therapy for infantile hemangioma using nonselective β-blockers, including oral propranolol and topical timolol.
  
  
  RESULTS
  Conventional treatments for infantile hemangioma include the use of corticosteroids, laser, surgery, and immunomodulator therapy. Recently, systemic and topical β-blockers have been used to successfully treat infantile hemangioma. The drugs' mechanism of action remains uncertain, but plausible theories include vasoconstriction, modulation of pro-survival signal transduction pathways, and endothelial cell apoptosis. Whereas no life-threatening adverse events from β-blocker treatment have been described, there have been reports of bradycardia, hypotension, bronchospasm, hypoglycemia, and electrolyte disturbances resulting from systemic use of propranolol to treat infantile hemangioma. Sleep and gastrointestinal disturbances have also been frequently reported. Topical timolol application for localized, superficial tumors may confer similar efficacy as oral propranolol while reducing systemic effects.
  
  
  CONCLUSIONS
  Despite the recent explosion of interest surrounding this novel treatment, current treatment and protocol-monitoring recommendations are based largely on the experience of individual centers. Several randomized controlled studies are currently underway, the results of which will guide future standard-of-care treatment for infantile hemangioma.
authors: Yale University School of Medicine, USA.
authors: Nina
authors: N
authors: Ni
authors: Suqin
authors: S
authors: Guo
authors: Paul
authors: P
authors: Langer
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D002675:Child, Preschool; D005142:Eyelid Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D018324:Hemangioma, Capillary / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D013999:Timolol / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D013999:Timolol; D011433:Propranolol