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.