The treatment of problematic hemangiomas in children with propranolol and 940nm diode laser

J Pediatr Surg. 2016 May;51(5):863-8. doi: 10.1016/j.jpedsurg.2016.02.038. Epub 2016 Feb 23.

Abstract

Background: Hemangiomas are common skin lesion, affecting 10-12% of children <1year of age. The purpose of this study was to determine the effect and safety of systemic propranolol (Pr) therapy in combination with 940nm diode laser for the treatment of severe hemangiomas.

Methods: Patients (123: 11 with vascular malformations and 112 with infantile hemangiomas (IH)) were enrolled in the study. They were initially treated with: systemic Pr therapy (2-2.5mg/kg/day) for 6-8months. Following completion of Pr therapy, patients with significant residual lesions (n-61) were treated with photothermolysis (laser therapy).

Results: Pr therapy had no effect on the color and volume of the vascular malformations. Pr therapy alone demonstrated a reduction in both volume and color of the IH. Laser therapy resulted in a continued improvement in the appearance of the IH with 84% of patients experiencing a residual volume of 0% compared to the original and 89% experiencing a decrease to between 0 and 20% of original color. There were no adverse events associated with laser therapy.

Conclusions: This study demonstrates that the addition of laser therapy to Pr therapy for the treatment of IH in children is well tolerated with a very acceptable cosmetic result.

Keywords: Children; Diode laser; Hemangiomas; Propranolol.

MeSH terms

  • Administration, Oral
  • Antineoplastic Agents / therapeutic use*
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Hemangioma / drug therapy*
  • Hemangioma / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Lasers, Semiconductor / therapeutic use*
  • Male
  • Propranolol / therapeutic use*
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / surgery*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Propranolol