Propranolol, a very promising treatment for ulceration in infantile hemangiomas: a study of 20 cases with matched historical controls
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Publication year
2011Source
Journal of the American Academy of Dermatology, 64, 5, (2011), pp. 833-8ISSN
Publication type
Article / Letter to editor
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Organization
Dermatology
Radiology
Surgery
Journal title
Journal of the American Academy of Dermatology
Volume
vol. 64
Issue
iss. 5
Page start
p. 833
Page end
p. 8
Subject
N4i 1: Pathogenesis and modulation of inflammation; N4i 1: Pathogenesis and modulation of inflammation NCEBP 2: Evaluation of complex medical interventions; NCEBP 14: Cardiovascular diseases; NCEBP 2: Evaluation of complex medical interventions; ONCOL 5: Aetiology, screening and detectionAbstract
BACKGROUND: Ulceration is a common but poorly understood complication of infantile hemangiomas (IH) that is difficult to control. OBJECTIVE: To investigate the possible role of monotherapy with propranolol for ulcerating IH. METHODS: Propranolol was given to 20 patients with IH, who suffered from ulceration at the start of treatment (mean age at onset of treatment, 3.5 months; standard error of the mean: 0.4). After cardiac screening, propranolol was administered in a progressive schedule to 2 to 2.5 mg/kg per day, divided in 3 doses. Blood pressure, heart rate, and fasting glucose levels were monitored during the first 3 days in hospital and, in the absence of complications, treatment was continued at home until the age of approximately 1 year. The 20 propranolol-treated patients were matched to patients from a historical control group, seen before the 'propranolol era'. These matches were randomly made by using clinical pictures based on type, location and size of the IH, extent of ulceration, and age at the start of ulceration. RESULTS: The time to complete healing from the onset of ulceration was significantly shorter for the propranolol-treated patients, compared with the control group (8.7 vs 22.4 weeks; t test: P < .015). In the propranolol group, a tendency to shorter ulceration duration was seen in patients starting propranolol at an earlier stage of disease. LIMITATIONS: The study was limited by the partially retrospective design and the small number of patients. CONCLUSION: Propranolol reduces the duration of ulceration in IH and seems to be more effective when started in an early phase. We propose propranolol as the treatment of first choice for ulcerating IH.
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- Academic publications [238426]
- Electronic publications [122508]
- Faculty of Medical Sciences [90358]
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