title: Ulcerated infantile hemangioma: novel treatment with topical brimonidine-timolol.
abstract: We report a 2-month-old boy with a painful ulcerated hemangioma on the lower mucosal lip extending to the vermillion border that caused feeding difficulty. It was successfully treated with topical brimonidine 0.2% and timolol 0.5%, a combination selective α2 -adrenergic agonist and nonselective β-blocker. After 6 weeks of treatment, the lesion reepithelialized and the patient's symptoms and functional complications resolved. Brimonidine 0.2% timolol 0.5% ophthalmic solution is an emerging alternative treatment for hemangiomas, offering the potential to target hemangioma growth through two synergistic mechanisms (β-inhibition and α2 -agonism) that may be especially effective for ulcerated lesions, the most common complication of infantile hemangiomas.
authors.affiliation: School of Medicine, Saint Louis University, St. Louis, Missouri.
authors.forename: Brandon T
authors.initials: BT
authors.lastname: Beal
authors.forename: Melinda B
authors.initials: MB
authors.lastname: Chu
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Siegfried
mesh_terms: D000287:Administration, Topical; D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000068438:Brimonidine Tartrate; D004359:Drug Therapy, Combination; D018324:Hemangioma, Capillary / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008048:Lip Neoplasms / Q000188:drug therapy*; D008297:Male; D011810:Quinoxalines / Q000008:administration & dosage / Q000627:therapeutic use*; D013999:Timolol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; D013999:Timolol