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Oral Propranolol in the Treatment of Cutaneous Infantile Hemangioma in Children: A 3-Years Retrospective Study

Nootchanard Rujimethapass¹, Srisupalak Singalavanija¹, Wanida Limpongsanurak¹, Chonnakarn Sukhneewat¹

Affiliation : ¹ Department of Pediatric Dermatology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand

Background: Infantile hemangioma is the most common vascular tumor in children. The primary pharmacological agent currently utilized for its treatment is propranolol, which demonstrates efficacy and minimal and non-severe side effects.
Objective: To investigate the therapeutic outcomes and adverse effects of orally administered propranolol in the treatment of infantile hemangioma. Additionally, to explore patient data regarding disease manifestations and progression.
Material and Methods: Retrospective data collection from medical records of patients diagnosed with cutaneous infantile hemangioma and treated at the National Children’s Health Institute for a duration of three years, between January 1, 2018 and December 31, 2020, was done.
Results: The present study included 180 patients with infantile hemangioma. The male-to-female ratio was 1 to 2.3. The median age at diagnosis and treatment initiation was four months, ranging from 1 week to 18 months. Premature infants accounted for 28 cases (15.6%). The most common locations were the head, face, and neck with 67.8%, trunk with 16.1%, and limbs with 16.1%. The most prevalent complications were ulcerations for 12.2% and visual field defects for 0.6%. The average duration of propranolol treatment was 13.01 months. Favorable response was noted in 173 patients (96%) at the 2-week follow-up. By the 6-month follow-up, all patients exhibited positive treatment responses. Adverse effects were reported in two cases, including hypoglycemic seizure and irritability.
Conclusion: Oral propranolol demonstrates favorable outcomes in treating infantile hemangioma. However, vigilant monitoring for severe adverse effects, particularly hypoglycemia-induced seizures must be done. Guardians must be informed and deeply concerned not to administer propranolol on an empty stomach, in the presence of poor feeding, or in poor physical condition.

Received 25 June 2024 | Revised 16 October 2024 | Accepted 25 October 2024
DOI: 10.35755/jmedassocthai.2024.12.950-955-01315

Keywords : Oral propranolol; Infantile hemangioma; Adverse events; Hypoglycemia


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