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Our Experience of Outpatient Treatment of Infantile Haemangiomas with Oral Propranolol

Received: 26 October 2021    Accepted: 26 November 2021    Published: 11 December 2021
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Abstract

Infantile hemangiomas are the most common benign vascular tumors in infancy. Their incidence is between 3-10%. They are more frequently observed in females, in preterm babies and in case of perinatal stress. Most of the infantile hemangiomas are benign and do not need systemic treatment, only 12-15% need an oral treatment with Propranolol. The invention of their treatment with oral Propranolol makes a huge revolution in their course. Oral Propranolol (Hemangiol sir) is already well known for accurate dosing and treatment of infantile hemangiomas. The accurate diagnosis and early treatment are very important for a child prognosis and hemangioma evolution. The treatment must be started in the stage of hemangioma progression in order to have a good final response. The treatment can be started in out- patient or in- patient option with good clinical effect and results. Patients must be prepared with laboratory investigations, dermatology and cardiology consultation. The dose is carefully increased from 1mg/kg to 2 mg/kg and 3 mg/kg/day in a week interval. The dose of 3 mg/kg is the therapeutic dose. We present our experience in management and treatment of infantile hemangiomas. In our clinic as an out – patients twenty patients are observed. Our results demonstrate very satisfied results in the involution of treated patients.

Published in American Journal of Internal Medicine (Volume 9, Issue 6)
DOI 10.11648/j.ajim.20210906.16
Page(s) 273-279
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Infantile Hemangiomas, Propranolol, Out-Patient Treatment

References
[1] Metry DW, Hebert AA. Benign Cutaneous vascular tumors of infancy. When to worry, what to do. Arch Dermatol 2000; 136: 905-14.
[2] Frieden IJ, Eichenfield LF, Esterly NB, Geronemus R, Mallory SB. Guidelines of care for hemangiomas of infancy. J Am Acad Dermatol 1997; 37: 631-7.
[3] Werner J, Dunne A, Lippert B, Folz B. Optimal treatment of vascular birthmarks. Am J Clin Dermatol 2003; 4: 745-56.
[4] Garzon MC, Frieden IJ. Hemangiomas: When to worry. Pediatr Ann 2000; 29: 58-67.
[5] Drolet BA, Esteryl NB, Frieden IJ. Hemangiomas in children. N Engl J Med 1999; 341: 173-81.
[6] Enjolras O, Gelbert F. Superficial hemangiomas: Association and management. Pediatr Dermatol 1997; 14: 173-9.
[7] Freiden IJ, Reese V, Cohen D. PHACE syndrome. Arch Dermatol 1996; 132: 307-11.
[8] Metry DW, Dowd CF, Barkovich AJ, Frieden IJ. The many faces of PHACE syndrome. J Pediatr 2001; 139: 117-23.
[9] Tanner JL, Dechert MP, Freiden IJ. Growing up with a facial hemangioma: parent and child coping and adaptation. Pediatrics 1998; 101: 446-83.
[10] Enjolras O, Riche MC, Merland JJ, Escande JP. Management of alarming hemangiomas in infancy: a review of 25 cases. Pediatrics 1990; 85: 491-8.
[11] Special symposium. Management of hemangiomas Pediatr Dermatol 1997; 14: 57-83.
[12] Frieden IJ, Haggstrom AN, Drolet BA, Mancini AJ, Friedlander SF, Boon L. Infantile hemangiomas: current knowledge, future directions: Proceedings of a research workshop on infantile hemangiomas, April 7-9, 2005, Bethesda, Maryland, USA. Pediatr Dermatol 2005; 22: 383-406.
[13] Lιautι-Labrθze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo J B, Taοeb A. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008; 358: 2649-2652.
[14] Fernández Faith E, Shah S, Witman PM, Harfmann K, Bradley F, Blei F, Pope E, Alsumait A, Gupta D, Covelli I, Streicher JL, Cotton C, Tollefson M, Nguyen H, Hunt R, Moore-Clingenpeel M, Frieden IJ - Clinical Features, Prognostic Factors, and Treatment Interventions for Ulceration in Patients With Infantile Hemangioma. JAMA Dermatol. 2021 May 1; 157 (5): 566-572. doi: 10.1001/jamadermatol.2021.0469.PMID: 33787840.
[15] Tiemann L, Hein S. Infantile Hemangioma: A Review of Current Pharmacotherapy Treatment and Practice Pearls. J Pediatr Pharmacol Ther. 2020; 25 (7): 586-599. doi: 10.5863/1551-6776-25.7.586.PMID: 33041713.
[16] Rachel A. Giese, Merit Turner, Mario Cleves, J. Reed Gardner, et al. Propranolol for Treatment of Infantile Hemangioma: Efficacy and Effect on Pediatric Growth and Development, Int J Pediatr. 2021; 2021: 6669383. Published online 2021 Apr 7.
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  • APA Style

    Rada Markova, Zdravka Demerdjieva, Jana Kazandjieva. (2021). Our Experience of Outpatient Treatment of Infantile Haemangiomas with Oral Propranolol. American Journal of Internal Medicine, 9(6), 273-279. https://doi.org/10.11648/j.ajim.20210906.16

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    ACS Style

    Rada Markova; Zdravka Demerdjieva; Jana Kazandjieva. Our Experience of Outpatient Treatment of Infantile Haemangiomas with Oral Propranolol. Am. J. Intern. Med. 2021, 9(6), 273-279. doi: 10.11648/j.ajim.20210906.16

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    AMA Style

    Rada Markova, Zdravka Demerdjieva, Jana Kazandjieva. Our Experience of Outpatient Treatment of Infantile Haemangiomas with Oral Propranolol. Am J Intern Med. 2021;9(6):273-279. doi: 10.11648/j.ajim.20210906.16

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  • @article{10.11648/j.ajim.20210906.16,
      author = {Rada Markova and Zdravka Demerdjieva and Jana Kazandjieva},
      title = {Our Experience of Outpatient Treatment of Infantile Haemangiomas with Oral Propranolol},
      journal = {American Journal of Internal Medicine},
      volume = {9},
      number = {6},
      pages = {273-279},
      doi = {10.11648/j.ajim.20210906.16},
      url = {https://doi.org/10.11648/j.ajim.20210906.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210906.16},
      abstract = {Infantile hemangiomas are the most common benign vascular tumors in infancy. Their incidence is between 3-10%. They are more frequently observed in females, in preterm babies and in case of perinatal stress. Most of the infantile hemangiomas are benign and do not need systemic treatment, only 12-15% need an oral treatment with Propranolol. The invention of their treatment with oral Propranolol makes a huge revolution in their course. Oral Propranolol (Hemangiol sir) is already well known for accurate dosing and treatment of infantile hemangiomas. The accurate diagnosis and early treatment are very important for a child prognosis and hemangioma evolution. The treatment must be started in the stage of hemangioma progression in order to have a good final response. The treatment can be started in out- patient or in- patient option with good clinical effect and results. Patients must be prepared with laboratory investigations, dermatology and cardiology consultation. The dose is carefully increased from 1mg/kg to 2 mg/kg and 3 mg/kg/day in a week interval. The dose of 3 mg/kg is the therapeutic dose. We present our experience in management and treatment of infantile hemangiomas. In our clinic as an out – patients twenty patients are observed. Our results demonstrate very satisfied results in the involution of treated patients.},
     year = {2021}
    }
    

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    T1  - Our Experience of Outpatient Treatment of Infantile Haemangiomas with Oral Propranolol
    AU  - Rada Markova
    AU  - Zdravka Demerdjieva
    AU  - Jana Kazandjieva
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    DO  - 10.11648/j.ajim.20210906.16
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    PB  - Science Publishing Group
    SN  - 2330-4324
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    AB  - Infantile hemangiomas are the most common benign vascular tumors in infancy. Their incidence is between 3-10%. They are more frequently observed in females, in preterm babies and in case of perinatal stress. Most of the infantile hemangiomas are benign and do not need systemic treatment, only 12-15% need an oral treatment with Propranolol. The invention of their treatment with oral Propranolol makes a huge revolution in their course. Oral Propranolol (Hemangiol sir) is already well known for accurate dosing and treatment of infantile hemangiomas. The accurate diagnosis and early treatment are very important for a child prognosis and hemangioma evolution. The treatment must be started in the stage of hemangioma progression in order to have a good final response. The treatment can be started in out- patient or in- patient option with good clinical effect and results. Patients must be prepared with laboratory investigations, dermatology and cardiology consultation. The dose is carefully increased from 1mg/kg to 2 mg/kg and 3 mg/kg/day in a week interval. The dose of 3 mg/kg is the therapeutic dose. We present our experience in management and treatment of infantile hemangiomas. In our clinic as an out – patients twenty patients are observed. Our results demonstrate very satisfied results in the involution of treated patients.
    VL  - 9
    IS  - 6
    ER  - 

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Author Information
  • Medical Centre “1-st Pediatric Consultative Clinic”, Sofia, Bulgaria

  • Department of Dermatology, “Tokuda” Hospital, Sofia, Bulgaria

  • Department of Dermatology, University Hospital “Alexandrovska”, Sofia, Bulgaria

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