Introduction
Infantile hemangiomas (IH) are the most common tumor of childhood with
an overall incidence of 4-5% 1,2. Typically, these
tumors arise within the first few weeks of life and have an initial
period of proliferation or active growth followed by a slow and
spontaneous involution phase 3. Despite their high
incidence, many IH do not require therapy as they often regress
spontaneously without complications. 4. However, in 10
to 15% of cases, treatment may be needed for complications such as
disfigurement, discomfort, ulceration, and in severe cases, vision loss,
airway compromise, visceral involvement, and cardiac insufficiency5.
Treatment of IH can be divided into medical and surgical interventions,
though multi-modal strategies may often be required. The oral
administration of propranolol has become the treatment of choice for
problematic infantile hemangiomas, as patients treated with this
modality have achieved significant resolution of their lesion within the
first few months of use 6,7. Propranolol has been
shown to be well tolerated by patients and adverse effects tend to be
minor in appropriately selected patients 8. Other less
common options include topical timolol and systemic steroids. Surgical
options include intralesional steroid injection, surgical excision, and
laser therapy.
Our study contributes to the current literature available by reporting
our institutional experience in the management of IH in pediatric
patients. This study describes the results of treating IH patients with
propranolol only or initial propranolol therapy followed by laser
therapy, surgical excision, corticosteroid therapy, or a second cycle of
propranolol. We aim to report the clinical presentations, predictive
factors, treatment modalities, and responses to therapy for children
with IH within a large patient cohort at a tertiary referral center.