Skip to main content

A Case of Ulcerated Hemangioma

  • 48 Accesses

Part of the Clinical Cases in Dermatology book series (CLIDADE)


A 1-year-old infantile male patient presented to us with a 60-mm × 40-mm right ear and face superficial protuberant infantile hemangioma that appeared at birth growing steadily over time and then gradually developed 30-mm × 35-mm ulceration of the inferior half over the last 6 weeks. In his medical history, he had systemic steroid, oral propranolol and sirolimus drug medication. With the regression of the lesion that benefited from the treatment, discontinued the treatment and relapsed. Prednizolon 1.5 mg/kg/day and propranolol 3 mg/kg/day were restarted by our pediatric oncology department. Prednizolon was discontinued in outpatient clinic examinations 1 month later. And then 2 drops of 0.5% betoxalol solution was applied thrice daily over the entire lesion by our dermatology department. The ulcer complete healing was achieved by 3 month, leaving a whitish scar. At monthly outpatient clinic reviews, the child’s recorded vital signs ranged as follows: heart rate, 120–135 beats per minute; blood pressure, 80–96/55–73 mmHg; and random glucose, 5.6–8.2 mmol/l. Propranolol and 0.5% betoxolol solution were continued for 6 months, and there was no ulcer recurrence at 12 months after stopping treatment.


  • Hemangioma
  • Propranolol
  • Prednisolon
  • Ulcer
  • Beta blockers
  • Pediatric cancer

This is a preview of subscription content, access via your institution.

Buying options

USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-030-93666-2_4
  • Chapter length: 4 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
USD   69.99
Price excludes VAT (USA)
  • ISBN: 978-3-030-93666-2
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   89.99
Price excludes VAT (USA)
Fig. 4.1
Fig. 4.2


  1. Frieden IJ, Eichenfield LF, Esterly NB, Geronemus R, Mallory SB. Guidelines of care for hemangiomas of infancy. American Academy of Dermatology Guidelines/Outcomes Committee. J Am Acad Dermatol. 1997;37(4):631–7.

    CAS  CrossRef  Google Scholar 

  2. Ozeki M, Nozawa A, Hori T, Kanda K, Kimura T, Kawamoto N, Fukao T. Propranolol for infantile hemangioma: effect on plasma vascular endothelial growth factor. Pediatr Int. 2016;58(11):1130–5.

    CAS  CrossRef  Google Scholar 

  3. Kum JJ, Khan ZA. Mechanisms of propranolol action in infantile hemangioma. Dermatoendocrinol. 2015;6(1):e979699.

    CrossRef  Google Scholar 

  4. Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, Guibaud L, Baselga E, et al. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med. 2015;372(8):735–46.

    CrossRef  Google Scholar 

  5. Shah SD, Baselga E, McCuaig C, Pope E, et al. Rebound growth of infantile hemangiomas after propranolol therapy. Pediatrics. 2016;137(4):e20151754.

    CrossRef  Google Scholar 

  6. Boos MD, Castelo-Soccio L. Experience with topical timolol maleate for the treatment of ulcerated infantile hemangiomas (IH). J Am Acad Dermatol. 2016;74(3):567–70.

    CrossRef  Google Scholar 

  7. Kim KH, Choi TH, Choi Y, Park YW, et al. Comparison of efficacy and safety between propranolol and steroid for infantile hemangioma: a randomized clinical trial. JAMA Dermatol. 2017;153(6):529–36.

    CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations


Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

Deniz, N., Türsen, Ü. (2022). A Case of Ulcerated Hemangioma. In: Satolli, F., Tirant, M., Wollina, U., Lotti, T.M. (eds) Clinical Cases in Pediatric Skin Cancers. Clinical Cases in Dermatology. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-93665-5

  • Online ISBN: 978-3-030-93666-2

  • eBook Packages: MedicineMedicine (R0)