Evaluation of intra-lesional corticosteroids in the treatment of peri-ocular haemangioma of infancy: still an alternative besides propranolol.
OBJECTIVE
Haemangioma of infancy (HOI) is the most frequently occurring benign tumour of infancy. Alarming HOI require treatment. Current therapy is empirically based; corticosteroids are often administered but in recent publications propranolol was reported to be more effective. Peri-ocular HOI are highly sensitive to corticosteroids. Our goal was to evaluate the effectiveness of intra-lesional corticosteroids in the treatment of peri-ocular HOI.


METHODS
We selected all patients with peri-ocular HOI who had only been treated with intra-lesional corticosteroids at our hospital from 1993 until 2009. Treatment was standardized according to a prospective protocol.


RESULTS
A total of n = 34 patients were included. There were no complications at all after therapy. A second intra-lesional injection was necessary in five patients. At follow-up after 6 and 12 months after injection, 94 and 91% of the patients, respectively, had regression of the HOI. Astigmatism, Haemangioma Activity Score and global assessments all had improved after therapy.


CONCLUSIONS
This study shows that intra-lesional therapy with corticosteroids is very safe in the treatment of peri-ocular HOI. It remains a good and safe alternative besides propranolol or when propranolol therapy is not possible (e.g. asthma, PHACE syndrome, and certain cardiac diseases).
Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Sherief R
SR
Janmohamed
Gerard C
GC
Madern
Klaske
K
Nieuwenhuis
Peter C J
PC
de Laat
Arnold P
AP
Oranje
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D005142:Eyelid Neoplasms / Q000188:drug therapy*; D005260:Female; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D015552:Injections, Intralesional; D008297:Male; D011433:Propranolol / Q000008:administration & dosage*; D011446:Prospective Studies
D000305:Adrenal Cortex Hormones; D011433:Propranolol