Cosmetic Dermatology and Hair Care

Biography

Biography: Bhargavi B Kola,

Abstract

Infantile hemangiomas are common benign neoplasms composed of proliferating endothelial-like cells that occur in approximately 10% of children. They are more common in Caucasians, girls, and premature infants. Most hemangiomas are cutaneous and uncomplicated, however about 12% may ulcerate, bleed, scar or cause functional impairment, requiring intervention. Most of the time, these cases require referral to specialists due to the fact that most pediatricians don’t feel comfortable treating them, especially that there are currently no uniform guidelines for treatment. This article sheds light on 3 different cases of hemangiomas that were presented in rural clinics and were treated with low dose propranolol. First case is an 8-month-old girl born prematurely at 32 weeks’ gestation and was noticed to have a small strawberry-colored tumor over the left side of her neck that was increasing in size rapidly.
The infant was referred to a pediatric dermatologist and was started initially on 0.25 mg propranolol daily and eventually dosage was increased to 0.5 mg twice a day. The growth was noted to stabilize over time however no significant reduction in size was observed. The second case presents an 8 week old girl, born full term, with no complications, came for her 2- month well-baby check up with complaints of prominent clear discharge from her right eye. MRI of the brain showed capillary hemangioma and the baby was referred to a pediatric ophthalmologist. She was then started on propranolol 3 mg/kg/day that were eventually tapered to 2 mg/kg/ day. A follow up MRI 2 months later showed a slight reduction in the bulk of the hemangioma and the mass effect of the lesion to the right globe appeared to have improved after the propranolol treatment. The third case presents a 2-month-old girl, born full term with no complications. Her mother had first noticed an abdominal mass at about 4 weeks of age that was progressively increasing in size. The patient was referred to a pediatric dermatologist for hemangioma of the anterior abdominal wall and was started on propranolol 2.8 mg twice a day. A follow up ultrasound will determine the effect of Propranolol treatment. Propranolol seemed to have impressive effects on our cases, and even though its use has grown in the recent years, a consensus about dosages to regress or even stabilize the size of the tumors has not been reached. An algorithm that would assist pediatricians in managing such cases is crucial especially in rural areas were specialists are hard to get to.