RESUMO
BACKGROUND: Propranolol, a nonselective ß-blocker, has been reported as efficient for controlling the growth of complicated infantile hemangiomas (IHs). No uniformly accepted protocol exists regarding the administration of oral propranolol for IH. OBJECTIVE: We sought to share our experience using propranolol for problematic IH and to evaluate the efficacy of this treatment modality. METHODS: A retrospective chart review analysis was performed for 35 consecutive children treated with propranolol as an oral solution on an outpatient basis in our dermatology/vascular anomalies clinic. A protocol was established with the help of our pediatric cardiologists, including pretreatment electrocardiography and echocardiography. Medical photographs taken after 2 months of treatment were rated by two independent evaluators. RESULTS: We treated 31 girls and 4 boys with a median age of 3.5 months. Rapid improvement was reported in the first days of treatment in 34 patients. Mean improvement after 2 months was 61.5%. No serious adverse effects were reported. CONCLUSION: Propranolol was effective in controlling the proliferative phase of problematic IH. It was well tolerated in our study. Outpatient treatment is possible if parents follow strict guidelines. Propranolol should be a first-line treatment for problematic IH in carefully selected patients.
Assuntos
Hemangioma/tratamento farmacológico , Hospitais Pediátricos , Seleção de Pacientes , Propranolol/administração & dosagem , Neoplasias Cutâneas/tratamento farmacológico , Administração Oral , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/uso terapêutico , Criança , Pré-Escolar , Diagnóstico Diferencial , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Hemangioma/patologia , Humanos , Lactente , Recém-Nascido , Masculino , Pacientes Ambulatoriais , Propranolol/uso terapêutico , Encaminhamento e Consulta , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Malformações VascularesRESUMO
BACKGROUND: Propranolol, a nonselective ß-blocker, has been reported as efficient for controlling the growth of complicated infantile hemangiomas (IHs). No uniformly accepted protocol exists regarding the administration of oral propranolol for IH. OBJECTIVE: We sought to share our experience using propranolol for problematic IH and to evaluate the efficacy of this treatment modality. METHODS: A retrospective chart review analysis was performed for 35 consecutive children treated with propranolol as an oral solution on an outpatient basis in our dermatology/vascular anomalies clinic. A protocol was established with the help of our pediatric cardiologists, including pretreatment electrocardiography and echocardiography. Medical photographs taken after 2 months of treatment were rated by two independent evaluators. RESULTS: We treated 31 girls and 4 boys with a median age of 3.5 months. Rapid improvement was reported in the first days of treatment in 34 patients. Mean improvement after 2 months was 61.5%. No serious adverse effects were reported. CONCLUSION: Propranolol was effective in controlling the proliferative phase of problematic IH. It was well tolerated in our study. Outpatient treatment is possible if parents follow strict guidelines. Propranolol should be a first-line treatment for problematic IH in carefully selected patients.
