Early propranolol treatment of infantile hemangiomas improves outcome

GIACHETTI, ANA; DÍAZ, MARÍA SOL; BOGGIO, PAULA; POSADAS MARTÍNEZ, MARÍA LOURDES

ANAIS BRASILEIROS DE DERMATOLOGIA

SOC BRASILEIRA DERMATOLOGIA

Año: 2022

0365-0596

Background: Infantile hemangiomas (IH) are the most common soft tissue tumors of childhood.Although most of these tumors are not worrisome, some IH may be life or function-threatening,can lead to permanent disfigurement, or have associated structural congenital anomalies,requiring early recognition and referral to specialists for treatment consideration. Since 2008,oral propranolol has been widely considered to be the first-line treatment for IH.Objectives: To evaluate aesthetic and functional outcome in propranolol-treated infantilehemangiomas according to the age of treatment onset.Methods: Retrospective, observational study of infantile hemangioma patients under 4 years ofage at the time of diagnosis, treated with oral propranolol. Evaluated parameters included: preand post-treatment morphologic/aesthetic aspects of the hemangioma, total resolution rate,degree of functional compromise of affected areas and its evolution. Two independent pediatricdermatologists evaluated all cases reviewing clinical data from medical records and comparingclinical photographs taken at initiation and at the end of treatment of each patient. Data wereanalyzed with STATA 13.0 program.Results: The cohort included 138 patients, with a female predominance. The median age attherapy onset was 3 months. The morphological/aesthetic improvement rate was 99% (95% CI96---99), the total resolution rate was 48% (95% CI 44---60) and the functional improvement ratereached 100%. When comparing total resolution outcome versus age when treatment started,the improvement was larger in younger patients (3.5 vs. 4.9 months, p = 0.01). When comparingthe total resolution rate in those younger or older than 3 months at treatment initiation, thepercentage of total resolution in the younger group was 57% vs. 40% in the older one (p = 0.05).Study limitations: Retrospective design; patients photographs were the sole indicators used tomeasure regression rates. Visual assessment is subjective. Study conducted at the Pediatric Dermatology Section of Pediatric Department of Hospital Italiano de Buenos Aires, CABA, Argentina.∗ Corresponding author.E-mail: ana.giachetti@hospitalitaliano.org.ar (A. Giachetti).https://doi.org/10.1016/j.abd.2022.04.0080365-0596/© 2022 Sociedade Brasileira de Dermatologia. Published by Elsevier Espa ̃na, S.L.U. This is an open access article under the CCBY license (http://creativecommons.org/licenses/by/4.0/).ABD-695; No. of Pages 6