Propranolol in the treatment of problematic infantile hemangioma: review of 35 consecutive patients from a vascular anomalies clinic

J Cutan Med Surg. 2012 Sep-Oct;16(5):317-23. doi: 10.1177/120347541201600508.

Abstract

Background: Propranolol, a nonselective β-blocker, has been reported as efficient for controlling the growth of complicated infantile hemangiomas (IHs). No uniformly accepted protocol exists regarding the administration of oral propranolol for IH.

Objective: We sought to share our experience using propranolol for problematic IH and to evaluate the efficacy of this treatment modality.

Methods: A retrospective chart review analysis was performed for 35 consecutive children treated with propranolol as an oral solution on an outpatient basis in our dermatology/vascular anomalies clinic. A protocol was established with the help of our pediatric cardiologists, including pretreatment electrocardiography and echocardiography. Medical photographs taken after 2 months of treatment were rated by two independent evaluators.

Results: We treated 31 girls and 4 boys with a median age of 3.5 months. Rapid improvement was reported in the first days of treatment in 34 patients. Mean improvement after 2 months was 61.5%. No serious adverse effects were reported.

Conclusion: Propranolol was effective in controlling the proliferative phase of problematic IH. It was well tolerated in our study. Outpatient treatment is possible if parents follow strict guidelines. Propranolol should be a first-line treatment for problematic IH in carefully selected patients.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / therapeutic use
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Hemangioma / drug therapy*
  • Hemangioma / pathology
  • Hospitals, Pediatric*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Outpatients
  • Patient Selection*
  • Propranolol / administration & dosage*
  • Propranolol / therapeutic use
  • Referral and Consultation
  • Retrospective Studies
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Vascular Malformations

Substances

  • Adrenergic beta-Antagonists
  • Propranolol