Hemangioma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]
Overview
Medical Therapy
- Medical and surgical options are available for the treatment of “problematic” hemangiomas.[1]
- Medical management includes one or more systemic therapies.
- For massive and life-threatening disease:[1]
-
- These agents have also been used for:
- Multifocal disease
- Visceral involvement
- Segmental distribution
- Airway obstruction
- Periorbital lesions
Intense pulsed light
- IPL flash lamps emit broadband polychromatic high-intensity light in the wavelength spectrum ranging 515-1200nm.[2]
- They target vessels at various depths inside the skin.
- The effect relies on selective photothermolysis.
- The indication spectrum includes vascular tumors including hemangiomas.
Propranolol
- A paradigm shift has occurred regarding the treatment of hemangiomas over the past few years.
- Propranolol, a nonselective β-adrenergic antagonist, was serendipitously discovered to cause regression of proliferating hemangiomas in newborns receiving treatment for cardiovascular disease.
- Numerous studies demonstrating the success of propranolol for shrinking hemangiomas
- Over ninety percent of patients have dramatic reduction in the size of their hemangiomas as early as 1-2 weeks following the first dose of propranolol.
- Dosing for propranolol in treating hemangiomas is recommended to be 2-3 mg/kg separated into two or three-times-a-day regimens.
- These doses are dramatically below the concentration employed for cardiovascular conditions in children.
References
- ↑ 1.0 1.1 Richter, Gresham T.; Friedman, Adva B. (2012). "Hemangiomas and Vascular Malformations: Current Theory and Management". International Journal of Pediatrics. 2012: 1–10. doi:10.1155/2012/645678. ISSN 1687-9740.
- ↑ Caucanas, Marie; Paquet, Philippe; Henry, Frédérique; Piérard-Franchimont, Claudine; Reginster, Marie-Annick; Piérard, Gérald E. (2011). "Intense Pulsed-Light Therapy for Proliferative Haemangiomas of Infancy". Case Reports in Dermatological Medicine. 2011: 1–5. doi:10.1155/2011/253607. ISSN 2090-6463.