title: Current trends in medical management of infantile hemangioma.
abstract: OBJECTIVE
  Infantile hemangiomas are the most common benign, soft-tissue tumors of infancy, affecting between 5 and 10% of newborns, and up to 30% of premature infants. Morbidity may include disfigurement and scarring, difficulty in feeding, ulceration, vision loss, airway compromise, congestive heart failure, and death. Advances in understanding the pathogenesis of infantile hemangiomas have given rise to a number of promising treatments. This article reviews the current options for medical management of infantile hemangiomas.
  
  
  RESULTS
  In the proliferative phase of infantile hemangiomas, vascular endothelial growth factor and basic fibroblast growth factor have shown increased expression, and vascular endothelial growth factor expression has been up-regulated by adrenergic stimulation. Moreover, the role of the renin-angiotensin system in the pathogenesis of infantile hemangiomas has been demonstrated. Numerous medical options have been under investigation. Since 2008, propanolol has become the first-line therapy, whereas other medical treatments are used less frequently or when propanolol is unsuccessful.
  
  
  CONCLUSIONS
  Propranolol has been recently adopted as the first-line medical treatment for complicated infantile hemangiomas. Although emerging treatment options and modalities have shown promising results, there need to be high-quality multicenter randomized trials to support these preliminary data.
authors.affiliation: Department of Otolaryngology/Facial Plastic Surgery, University of California, Davis Health System, California, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Ames
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Sykes
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D061345:Early Medical Intervention; D004954:Esthetics; D005938:Glucocorticoids / Q000627:therapeutic use*; D006391:Hemangioma / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011433:Propranolol / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D000319:Adrenergic beta-Antagonists; D003879:Dermatologic Agents; D005938:Glucocorticoids; D011433:Propranolol