Treatment Course
The primary treatment indication was cosmetic disfigurement (68%). The
majority of patients initiated treatment before the age of 6 months
(71%) and continued the propranolol for more than 6 months (69%), with
a mean length of 10.7 months. Most patients (98%) began treatment at a
dose of 2 mg/kg/d. A partial response to propranolol was seen in 18% of
patients, a nearly complete response in 52%, and a complete response,
defined as total resolution of the hemangioma, in 28% (Table 2). Upon
discontinuation of propranolol, 14 patients (4%) required a second
round of propranolol for regrowth (Table 3). Twenty-one patients (6%)
discontinued propranolol due to adverse events, including hypoglycemia,
bronchospasms, irritability/agitation, vomiting, diarrhea, and fatigue.
In addition to propranolol therapy, 24 patients received laser
treatment, 32 received surgical excision, and 12 received oral
corticosteroids. When controlling for location, a longer duration of
treatment (≥6 months vs < 6 months) decreased the risk of
needing surgical excision (OR, 0.51; 95% CI 0.31-0.82) (p=0.006).