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Propranolol is more effective than pulsed dye laser and cryosurgery for infantile hemangiomas

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Abstract

Propranolol hydrochloride is a nonselective β-blocker that is used for the treatment of hypertension, arrhythmia, and angina pectoris. In Japan, it was recently approved for the treatment of childhood arrhythmia. It has been observed to produce drastic involution of infantile hemangiomas. The aim of this prospective study was to examine propranolol’s superiority to classical therapy with pulsed dye laser and/or cryosurgery in treating proliferating infantile hemangiomas. Fifteen patients between the ages of 1 and 4 months with proliferating infantile hemangiomas received grinded propranolol tablets 2 mg/kg per day divided in three doses. Twelve patients with proliferating infantile hemangiomas receiving pulsed dye laser and/or cryosurgery were enrolled as controls. Baseline electrocardiogram, echocardiogram, and chest x-ray were performed. Monitoring of heart rate, blood pressure, and blood glucose was performed every 2 weeks. Efficacy was assessed by performing blinded volume measurements and taking photographs at every visit. Propranolol induced significantly earlier involution and redness reduction of infantile hemangiomas, compared to pulsed dye laser and cryosurgery. Adverse effects such as hypoglycemia, hypotension, or bradycardia did not occur. Conclusion: The dramatic response of infantile hemangiomas to propranolol and few side effects suggest that early treatment of infantile hemangiomas could result in decreased disfigurement. Propranolol should be considered as a first-line treatment of infantile hemangiomas.

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Abbreviations

IH:

Infantile hemangiomas

VEGF:

Vascular endothelial growth factor

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Acknowledgements

There is no funding resource that supported this work and the authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan

    Shinji Kagami, Yoshihiro Kuwano, Sayaka Shibata, Yuta Uwajima, Daisuke Yamada, Akie Miyamoto, Takuya Miyagawa, Mayuko Araki, Kohji Takahashi, Sayako Isomura, Naohiko Aozasa, Yuri Masui, Mizuho Yamamoto & Shinichi Sato

  2. Department of Dermatology, Kanto Central Hospital, 6-25-1 Kamiyoga, Setagaya-ku, Tokyo, 158-8531, Japan

    Shinji Kagami

  3. Department of Pediatrics, Faculty of Medicine, University of Tokyo, Tokyo, Japan

    Ryo Inuzuka & Tatsuo Katori

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  1. Shinji Kagami
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Correspondence to Shinji Kagami.

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Kagami, S., Kuwano, Y., Shibata, S. et al. Propranolol is more effective than pulsed dye laser and cryosurgery for infantile hemangiomas. Eur J Pediatr 172, 1521–1526 (2013). https://doi.org/10.1007/s00431-013-2075-7

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  • DOI: https://doi.org/10.1007/s00431-013-2075-7

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