Abstract
Background
Oral propranolol accelerates the involution of infantile haemangiomas (IHs). However, it is not clear whether IHs treated with oral propranolol are associated with fewer sequelae than when left untreated.
Objectives
To quantify and describe sequelae associated with IHs treated with oral propranolol, and to explore whether treated IHs are associated with fewer sequelae than untreated IHs.
Materials & Methods
This multicentre, retrospective, cohort study included patients with IH treated with oral propranolol ≥2 mg/kg for at least six months, with photographic images available at baseline and at age 4–5 years. A historical comparison cohort comprised 185 patients with untreated IHs. Main outcomes/measures were: IH features, treatment characteristics and type/degree of sequelae.
Results
Oral propranolol, most commonly at 2 mg/kg/day (mean duration: nine months), was initiated in 171 patients (mean age: 6.02 months). After treatment, 125 of 171 (73.1%) IHs were associated with no/minimal sequelae. The most common sequelae were telangiectasia (78%), fibrofatty tissue (37%) and anetodermic skin (28%). Deep IHs were associated with significantly fewer sequelae than other subtypes. Ulceration appeared to increase the likelihood of severe sequelae. IHs with a stepped border was associated with more severe sequelae than those with a progressive border (44% versus 27%, p < 0.05). Treated IHs resolved without sequelae or were associated with a sequela that did not need correction in 27.7% more cases than untreated IHs (RR: 1.61; p < 0.001).
Conclusion
Among IHs treated with oral propranolol, 73% resolved without, or were associated with minimal sequelae. Deep IHs were associated fewer sequelae than other sub-types. Oral propranolol decreased the likelihood of IH sequelae requiring correction
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Funding
This investigator initiated study was sponsored by Dr Eulalia Baselga. The study received the support of Pierre Fabre Dermatologie.
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Disclosures
Conflicts of interest: E. Baselga, M. El Hachem, and A. Torrelo received fees from Pierre Fabre Dermatologie. All other authors have no conflicts of interest to disclose.
Additional Contributions
The authors thank David P. Figgitt PhD, ISMPP CMPP™, and Kathy Croom, Content Ed Net, for providing editorial assistance with the manuscript, which was funded by Pierre Fabre Dermatologie, Lavaur, France. The authors thank the patients and their parents/legal guardians for granting permission to publish information and photographs associated with this study.
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Baselga, E., El Hachem, M., Diociaiuti, A. et al. Sequelae following infantile haemangiomas treated with propranolol. Eur J Dermatol 31, 785–790 (2021). https://doi.org/10.1684/ejd.2021.4172
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DOI: https://doi.org/10.1684/ejd.2021.4172