Current drug therapies for infantile hemangioma: focused on beta blocker

Seok-Jong Lee; Sang-Bum Lee; Ho Yun Chung; Jong Min Lee; Seung Huh Lee

doi:10.5124/jkma.2011.54.8.876

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Lee, Lee, Chung, Lee, and Lee: Current drug therapies for infantile hemangioma: focused on beta blocker

Pharmacotherapeutics

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(8): 876-883.

Published online: 9 August 2011

DOI: https://doi.org/10.5124/jkma.2011.54.8.876

Current drug therapies for infantile hemangioma: focused on beta blocker

Seok-Jong Lee, MD^1,², Sang-Bum Lee, MD³, Ho Yun Chung, MD⁴, Jong Min Lee, MD⁵, Seung Huh Lee, MD⁶

¹Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea.

²Vascular Anomalies Center, Kyungpook National University School of Medicine, Daegu, Korea.

³Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.

⁴Department Plastic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

⁵Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea.

⁶Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

Corresponding author: Seok-Jong Lee, seokjong@knu.ac.kr

Received 27 June 2011 Accepted 10 July 2011

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Infantile hemangioma (IH), a common vascular tumor from vascular birth marks, used to be untreated due to its natural course of spontaneous regression with few exceptions like cosmetic disfigurement, functional or life impairment. It has been treated through a variety of methods like the topical and systemic corticosteroid, surgery, laser, etc. Among them, systemic corticosteroid, which has been used most commonly, may sometimes cause troublesome side effects such as temporary growth retardation or personality change, so it is often clinically inapplicable. Recently, however, it was reported that treatment using beta blocker for IH is more effective with fewer side effects than conventional treatments. Oral beta blocker has been used for IH patients who concerns about presenting ulcerative lesions, impending cosmetic sequelae or functional and life impairment. Before the administration of beta blocker, the patient goes through inquiry about clinical history, physical examination, electrocardiogram and echocardiography in order to determine the applicability. During the hospital stay, vital signs and blood glucose level are checked regularly to rule out side effects of beta blocker, and the dosage is increased gradually up to 2 mg/kg/day and the same dose is maintained continuously after discharge with same dosage. After considering many previous studies about beta blocker for IH patients, we reached an interim conclusion. The treatment of IH using beta blocker is effective, highly satisfactory and safe with no side effects though the selection from various beta blockers, evaluation methods of therapeutic efficacy and its duration and end point of treatment need to be confirmed.

Keywords: Beta blocker, Corticosteroid, Infantile hemangioma

Figures and Tables

Figure 1

Patient case: (A) pretreatment, (B) no improvement after 3 months of steroid treatment, (C) marked improvement after 2 months of propranolol (Indenol®) treatment and (D) continued improvement after 4 months of treatment. Informed consent was received from parents of the patient.

Table 1

International Society for the Study of Vascular Anomalies classification of vascular anomalies

RICH, rapidly involuting congenital hemangioma; NICH, noninvoluting congenital hemangioma; C, capillary; V, venous; M, malformation; GV, glomuvenous; L, lymphatic; A, arterial; AV, arteriovenous; F, fistula.

Acknowledgement

I would like to express my sincere gratitude to Dr. Chang Hyun Song, Department of Dermatology, Kyung-pook National University School of Medicine for reviewing the manuscript.

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