Propranolol in the management of infantile hemangiomas: clinical response and predictors.
BACKGROUND
Recent data suggest that propranolol is an effective treatment for infantile hemangiomas (IHs). Data on the optimal dose, duration of therapy, and predictors of response are currently lacking.


OBJECTIVE
To assess the clinical response to and predictors of propranolol use in the treatment of IH.


METHODS
Retrospective cohort study of 44 patients. Two independent assessors evaluated improvement by comparing serial digital photographs using a 100 mm visual analogue scale (VAS), where 5 mm change represented 10% change in the size or appearance of the IH.


RESULTS
Propranolol was started at a mean age of 7.8 (SD 8.21) months and was used for 7.3 (SD 4.8) months before weaning. The mean percent improvement compared to baseline (as measured by the VAS) was 78% (SD 23%). Minor adverse events were noted in 32% of patients. The most significant predictor of regrowth after weaning was a IH > 5 cm in size (p  =  .017).


CONCLUSIONS
Propranolol is effective in IH, but the side effects and the possibility of regrowth should be considered.
Pediatric Dermatology, The Hospital for Sick Children, Toronto, ON.
Alexandra
A
Balma-Mena
Ajith
A
Chakkittakandiyil
Miriam
M
Weinstein
Perla
P
Lansang
Nhung
N
Ho
Salvatore
S
Cammisuli
Elena
E
Pope
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D018324:Hemangioma, Capillary / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009386:Neoplastic Syndromes, Hereditary / Q000188:drug therapy*; D010781:Photography; D011433:Propranolol / Q000627:therapeutic use*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D011433:Propranolol