title: Propranolol: Effectiveness and Failure in Infantile Cutaneous Hemangiomas.
abstract: Infantile hemangiomas (IHs) occur in early infancy and are considered to be one of the most frequent childhood tumors. Poor responsiveness to the treatment and complications are reported in about 10 % of patients. For years, the most common treatments for cutaneous and complicated IHs were corticosteroids, interferon-α, vincristine, laser therapy, or surgical intervention. More recently, treatment with propranolol has been reported with high success rates, both in the cutaneous and complicated form of IHs, and it is now considered to be the first-line treatment for IHs. Herein we report five cases of cutaneous IHs who presented at our unit between January 2011 and June 2012: in three of five patients, the lesion improved soon after the beginning of propranolol treatment; one case presented slow but complete resolution; and in one patient the treatment was unsuccessful. Patients who do not respond to propranolol have been seldom reported in the literature. However, the failure of propranolol treatment in childhood hemangiomas has been more frequent in our experience than that reported in previous case series. More attention should be given to the cases that poorly or negatively respond to treatment, and to the mechanisms underlying the failure to respond to treatment with propranolol.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, Catania, Italy. terrenere178@tin.it.|Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy. terrenere178@tin.it.
authors.forename: Andrea Domenico
authors.initials: AD
authors.lastname: Praticò
authors.affiliation: Department of Educational Sciences, University of Catania, Catania, Italy.|IRCCS Associazione Oasi Maria S.S., Institute for Research on Mental Retardation and Brain Aging, Troina, Enna, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Caraci
authors.affiliation: Unit of Pediatrics and Pediatric Emergency "Costanza Gravina", University-Hospital "Vittorio Emanuele-Policlinic", Catania, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Pavone
authors.affiliation: Unit of Pediatrics and Pediatric Emergency "Costanza Gravina", University-Hospital "Vittorio Emanuele-Policlinic", Catania, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Falsaperla
authors.affiliation: Chair of Pharmacology, Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Drago
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, Catania, Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Ruggieri