Evaluation of intra-lesional corticosteroids in the treatment of peri-ocular haemangioma of infancy: still an alternative besides propranolol
Haemangioma of infancy (HOI) is the most frequently occurring benign tumour of infancy. Alarming HOI require treatment. Current therapy is empirically based; corticosteroids are often administered but in recent publications propranolol was reported to be more effective. Peri-ocular HOI are highly sensitive to corticosteroids. Our goal was to evaluate the effectiveness of intra-lesional corticosteroids in the treatment of peri-ocular HOI.
We selected all patients with peri-ocular HOI who had only been treated with intra-lesional corticosteroids at our hospital from 1993 until 2009. Treatment was standardized according to a prospective protocol.
A total of n = 34 patients were included. There were no complications at all after therapy. A second intra-lesional injection was necessary in five patients. At follow-up after 6 and 12 months after injection, 94 and 91% of the patients, respectively, had regression of the HOI. Astigmatism, Haemangioma Activity Score and global assessments all had improved after therapy.
This study shows that intra-lesional therapy with corticosteroids is very safe in the treatment of peri-ocular HOI. It remains a good and safe alternative besides propranolol or when propranolol therapy is not possible (e.g. asthma, PHACE syndrome, and certain cardiac diseases).
- Bruckner AL, Frieden IJ (2003) Hemangiomas of infancy. J Am Acad Dermatol 48(4):477–493 (quiz 494–476) CrossRef
- Boye E, Olsen BR (2009) Signaling mechanisms in infantile hemangioma. Curr Opin Hematol 16(3):202–208 CrossRef
- Chang EI, Chang EI, Thangarajah H, Hamou C, Gurtner GC (2007) Hypoxia, hormones, and endothelial progenitor cells in hemangioma. Lymphat Res Biol 5(4):237–243 CrossRef
- Bruckner AL, Frieden IJ (2006) Infantile hemangiomas. J Am Acad Dermatol 55(4):671–682 CrossRef
- Lo K, Mihm M, Fay A (2009) Current theories on the pathogenesis of infantile hemangioma. Semin Ophthalmol 24(3):172–177 CrossRef
- Sun ZY, Yi CG, Zhao H, Yin GQ, Gao M, Liu YB, Qin JD, Wang SF, Guo SZ (2008) Infantile hemangioma is originated from placental trophoblast, fact or fiction? Med Hypotheses 71(3):444–448 CrossRef
- Kushner BJ (1982) Intralesional corticosteroid injection for infantile adnexal hemangioma. Am J Ophthalmol 93(4):496–506
- Leaute-Labreze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taieb A (2008) Propranolol for severe hemangiomas of infancy. N Engl J Med 358(24):2649–2651 CrossRef
- Sans V, de la Roque ED, Berge J, Grenier N, Boralevi F, Mazereeuw-Hautier J, Lipsker D, Dupuis E, Ezzedine K, Vergnes P, Taïeb A, Léauté-Labrèze C (2009) Propranolol for severe infantile hemangiomas: follow-up report. Pediatrics 124(3):e423–e431
- Weiss AH, Kelly JP (2008) Reappraisal of astigmatism induced by periocular capillary hemangioma and treatment with intralesional corticosteroid injection. Ophthalmology 115(2):390–397 e391 CrossRef
- Lawley LP, Siegfried E, Todd JL (2009) Propranolol treatment for hemangioma of infancy: risks and recommendations. Pediatr Dermatol 26(5):610–614 CrossRef
- Boye E, Jinnin M, Olsen BR (2009) Infantile hemangioma: challenges, new insights, and therapeutic promise. J Craniofac Surg 20(Suppl 1):678–684 CrossRef
- Janmohamed SR, de Waard-van der Spek FB, Madern GC, de Laat PC, Hop WC, Oranje AP (2011) Scoring the proliferative activity of haemangioma of infancy: the Haemangioma Activity Score (HAS). Clin Exp Dermatol 36(7):715–723 CrossRef
- Verity DH, Rose GE, Restori M (2008) The effect of intralesional steroid injections on the volume and blood flow in periocular capillary haemangiomas. Orbit 27(1):41–47 CrossRef
- Nguyen J, Fay A (2009) Pharmacologic therapy for periocular infantile hemangiomas: a review of the literature. Semin Ophthalmol 24(3):178–184 CrossRef
- Sidbury R (2010) Update on vascular tumors of infancy. Curr Opin Pediatr 22(4):432–437 CrossRef
- Greenberger S, Boscolo E, Adini I, Mulliken JB, Bischoff J (2010) Corticosteroid suppression of VEGF-A in infantile hemangioma-derived stem cells. N Engl J Med 362(11):1005–1013 CrossRef
- Evaluation of intra-lesional corticosteroids in the treatment of peri-ocular haemangioma of infancy: still an alternative besides propranolol
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Pediatric Surgery International
Volume 28, Issue 4 , pp 393-398
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- 1. Department of Paediatric Surgery, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- 2. KinderHaven, Havenziekenhuis, Rotterdam, The Netherlands
- 3. Division of Paediatric Dermatology, Department of Paediatrics, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Room Sp-1528, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- 4. Department of Paediatrics, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- 5. Department of Dermatology, Maasstadziekenhuis, Rotterdam, The Netherlands