Propranolol reduces infantile hemangioma volume and vessel density.
OBJECTIVE
To evaluate changes in infantile hemangioma tissue before and after propranolol therapy, using gray-scale and color Doppler ultrasound imaging.


METHODS
Case series with chart review.


METHODS
Tertiary pediatric hospital.


METHODS
Medical records and image studies of head and neck infantile hemangioma patients treated with propranolol, identified in a quality improvement database, were reviewed. Patients with imaging before and at least 4 weeks following the initiation of treatment were included. Data collected included sex, age, location, and concurrent treatment. Student t tests were used to evaluate change in cutaneous lesion area, volume, and vessel density. Logistic regression was used to compare lesion area, volume, and vessel density.


RESULTS
Of the 177 patients identified, 19 met inclusion criteria. Fourteen of 19 were female, and 5 of 19 were older than 1 year. Mean lesion area change with treatment was 13.0 cm(2) (range, -2.8 to 28.9 cm(2), P = .05). Measured volume change was a mean of 10.3 cm(3) (range, 1.5-19.2 cm(3), P = .01). Mean vessel density change was 4.4 vessels per cm(2) (range, 2.5-6.3 vessels per cm(2), P < .01). Treatment decreased clinically determined hemangioma area proportionately less than gray-scale and color Doppler ultrasound measured lesion volume. Gray-scale and color Doppler ultrasound measured treatment response did not differ with sex, lesion location, or age at propranolol initiation.


CONCLUSIONS
Gray-scale and color Doppler ultrasound imaging of propranolol-treated infantile hemangiomas detected a significant reduction in lesion volume and vessel density. Patient age at propranolol treatment and concomitant corticosteroid use did not affect lesion volume change.
University of Washington School of Medicine, Seattle, Washington, USA.
Matthew M
MM
Bingham
Babette
B
Saltzman
Nghia-Jack
NJ
Vo
Jonathan A
JA
Perkins
D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology
D011433:Propranolol