title: Treatment of infantile hemangiomas: therapeutic options in regard to side effects and adverse events - a review of the literature.
abstract: BACKGROUND
  While options for treatment strategies for infantile hemangiomas (IH) are numerous, evidence-based information about agents, optimal dosage, adverse effects, treatment modality, pretreatment and treatment strategies remain limited.
  
  
  METHODS
  To evaluate side effects and adverse events of medical treatment in children with infantile hemangioma, a comprehensive review of the literature was performed to provide information for daily practice. In total 254 studies were retrieved from medical databases and comprised 10,022 patients divided into 5 different treatment groups. Information about working mechanism, side effects and adverse events of therapies used as a single agent for IH are discussed and evaluated according to information from pharmacotherapeutic databases. Randomized controlled trials have only scarcely been performed for the many therapeutic options reported for IH. Short- and long-term side effects and adverse events, have not been systematically studied. Subsequently information about the medical treatment options and pharmacotheraputic databases for therapy in children with IH are incomplete.
  
  
  CONCLUSIONS
  From the many therapeutic options, propranolol is the first-line approach for IH, predominantly based on clinical observation, efficacy and tolerability in the short-term. The unsolved ravels of possible short and long-term adverse events of propranolol used during early developmental stages of children need thorough review.
authors.affiliation: a Department of Pediatric Dermatology and Allergology , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Martine F
authors.initials: MF
authors.lastname: Raphael
authors.affiliation: b Department of Pediatric Cardiology , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Johannes M P J
authors.initials: JM
authors.lastname: Breur
authors.affiliation: a Department of Pediatric Dermatology and Allergology , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Florine A E
authors.initials: FA
authors.lastname: Vlasveld
authors.affiliation: c Department of Pediatric Dermatology , Erasmus University Medical Center Rotterdam , Rotterdam , The Netherlands.
authors.forename: Niels J
authors.initials: NJ
authors.lastname: Elbert
authors.affiliation: d Department of Clinical Pharmacy , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Yves T B
authors.initials: YT
authors.lastname: Liem
authors.affiliation: e Department of Pediatric Plastic Surgery , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Moshe
authors.initials: M
authors.lastname: Kon
authors.affiliation: e Department of Pediatric Plastic Surgery , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
authors.affiliation: a Department of Pediatric Dermatology and Allergology , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands.|c Department of Pediatric Dermatology , Erasmus University Medical Center Rotterdam , Rotterdam , The Netherlands.
authors.forename: Suzanne G M A
authors.initials: SG
authors.lastname: Pasmans
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol
keywords: Adverse events; infantile hemangioma; side effects and therapy