Infantile hemangioma treatment with topical and systemic betablockers : an experience at royal medical services hospitals

Abstract EN

Objective: Infantile hemangioma is the most common benign tumor in the neonatal age group.(1,2) Which is characterized by rapid growth during the first several months of life, followed by slow spontaneous involution in the following years.

Topical and systemic B-blocker therapy has been observed to stop rapid proliferation and accelerate regression of infantile hemangioma.(1,2,3) Methods: A simple statistical analysis was performed on patients who presented with infantile hemangioma and who were then treated with topical Timolol or oral Propranolol in our general dermatology clinics at Prince Hashem Hospital / Al-Zarqa and King Hussein Hospital /Amman, in the period between September 2015 and September 2017.

Non of patients had received any prior treatment for the infantile hemangioma.

Our Data include age, gender, site of hemangioma, treatment used, and duration of treatment, efficacy and adverse effects.

Results: 35 patients were diagnosed to have infantile hemangioma, Clinical diagnosis was made on all cases.

Our sample had 27 female patients and 8 male patients.

The mean age at presentation was 5.48 months.

According to the location of the Infantile Hemangioma; 66% of patients had their lesions over head and neck, 20% of patients had lesions over extremities, and the remaining 14% had their lesions over trunk.

21 patients (60%) had mixed lesions with a superficial and deep components, 11 patients (31%) had superficial infantile hemangioma, 3 patients (9%) had deep lesions.

7 patients were treated with topical Timolol, for the mean duration of 7.4 months.

Topical Timolol was given to 6 patients who had small superficial hemangiomas and 1 patient who had mixed component hemangioma, but for whom the parents refused the systemic Propranolol.The remaining 28 patients were treated with systemic Propranolol for the mean duration of 12.0 months.

Systemic Propranolol was given for 27 patients who had mixed or deep hemangiomas and to 1 patient with superficial hemangioma over face.

All patients showed almost complete clinical regression of the lesions with no recurrence, during the 6 months follow up period after stopping treatment.

Propranolol treatment was discontinued in 3 patients due to respiratory events.

Conclusions: Topical Timolol and oral Propranolol are a very effective treatment for infantile hemangioma.

Oral Propranolol can be safely initiated in an outpatient basis in infants older than 2 months of age