title: Incidence and treatment of infantile haemangioma in preterm infants.
abstract: Infantile haemangioma (IH) are vascular tumours with a unique growth dynamic, mostly absent at birth, growth in the first months followed by involution over several years, often resulting in residual skin changes. Immune-histologically, IH cells are exclusively glucose transporter protein-1 positive.The incidence of IH is increasing with decreasing gestational age, from 1-4% in term infants to 23% in those of <1000 g birth weight, with a female and Caucasian predominance. Discovery of systemic and topical beta blockers as an effective treatment option resulted in a rapid shift away from systemic steroids towards these drugs. For preterm infants, however, data on efficacy, pharmacokinetics and long-term safety are sparse or absent. Topical treatment without systemic side effects like cryotherapy may thus be an attractive alternative at an early growth stage (<10 mm). Indications for treatment with beta blockers, mostly propranolol systemically and timolol maleat 0.5% topically, are currently extrapolated from studies in older infants. Both seem effective, but adverse effects on sleep, circulation and metabolism are well described for propranolol. Long-term outcome data for either drug are missing. In conclusion, evidence on optimal IH treatment in preterms is lacking despite their high incidence; pharmacokinetic and clinical studies are warranted.
authors.affiliation: Department of Neonatology, University Children's Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Rangmar
authors.initials: R
authors.lastname: Goelz
authors.affiliation: Department of Neonatology, University Children's Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D017679:Cryotherapy; D006391:Hemangioma / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000628:therapy*; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D013999:Timolol; D011433:Propranolol
keywords: Infantile Haemangioma; Neonatology; incidence; preterm; treatment