title: Scoring the therapeutic effects of oral propranolol for infantile hemangioma: A prospective study comparing the Hemangioma Activity Score (HAS) with the Hemangioma Severity Scale (HSS).
abstract: BACKGROUND
  Validated and reliable instruments to measure disease severity are needed to substantiate the benefit of therapies for infantile hemangioma. Two purpose-made systems have been described: the Hemangioma Activity Score (HAS) and the Hemangioma Severity Scale (HSS).
  
  
  OBJECTIVE
  We sought to compare the HAS with the HSS in terms of ease of use, accuracy, and outcome in infants treated with oral propranolol.
  
  
  METHODS
  A prospective study of 54 infants with infantile hemangioma was conducted from October 2009 to December 2012. Propranolol was initiated at 0.5 mg/kg/d and increased to 2 mg/kg/d on day 3. The HAS and the HSS were applied independently by 2 observers.
  
  
  RESULTS
  Intraclass correlation coefficients of the HAS and HSS between the observers was comparable but HSS scores often remained the same upon improvement of the infantile hemangioma and therefore did not reflect disease severity. HAS decreased over time, with a dramatic drop in the first week reflecting an immediate therapeutic response.
  
  
  CONCLUSIONS
  This is a single-institution study and there may have been some selection bias in the patients who were referred for treatment.
  
  
  CONCLUSIONS
  This study suggests that the HAS is preferable to the HSS in evaluating infantile hemangioma response to treatment.
authors.affiliation: Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Sherief R
authors.initials: SR
authors.lastname: Janmohamed
authors.affiliation: Department of Pediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Marleen
authors.initials: M
authors.lastname: van Oosterhout
authors.affiliation: Department of Pediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Peter C J
authors.initials: PC
authors.lastname: de Laat
authors.affiliation: Department of Biostatistics, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: van Rosmalen
authors.affiliation: Department of Pediatric Surgery, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Gerard C
authors.initials: GC
authors.lastname: Madern
authors.affiliation: Department of Dermatology, Maasstad Hospital, Rotterdam, The Netherlands. Electronic address: a.oranje@inter.nl.net.
authors.forename: Arnold P
authors.initials: AP
authors.lastname: Oranje
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009386:Neoplastic Syndromes, Hereditary / Q000188:drug therapy* / Q000503:physiopathology*; D009426:Netherlands; D015588:Observer Variation; D011433:Propranolol / Q000008:administration & dosage*; D011446:Prospective Studies; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol
keywords: Hemangioma Activity Score; Hemangioma Severity Scale; disease severity scale; infantile hemangioma; scoring system