Oral B-blockers versus intralesional corticosteroids in treatment of infantile cutaneous hemangiomas

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Abstract

Aim
Infantile hemangioma (IH) is one of the most common benign tumors of childhood, with an incidence of between 4 and 10%. Multiple modalities for treatment for IH were proposed, most commonly B-blockers and corticosteroids. Our study objective was to compare between oral B-blockers and intralesional corticosteroids injections in treatment of IHs.
Patients and methods
This was a prospective study that included 52 patients diagnosed with IH in two pediatric surgery tertiary centers in Egypt. Patients were divided into two groups: group A patients underwent intralesional injection of betamethasone at a dose of 10–40 mg/ml in three to six separate sessions at an interval of 1 month, whereas group B patients were given oral propranolol at a low dose of 0.5–1 mg/kg/day for 3–6 months. Changes in size and color of the hemangioma each month and the occurrence of any complications were recorded for 6 months. Regression of size was classified into excellent (75–100% decrease in size), good (50–75% decrease), poor (25–50% decrease), and no response.
Results
‘Good’ response to intralesional corticosteroids was achieved in nine patients, whereas most patients had either ‘poor’ or ‘no response’ (=14). On the contrary, most patients in the propranolol group exhibited ‘excellent’ or ‘good’ response (=21) with only four patients not responding to treatment. Ulceration occurred in two patients who underwent intralesional steroid injection, whereas hypotension occurred in one patient with B-blockers.
Conclusion
Our study confirms the superiority of oral B-blockers in treatment of superficial IH when compared with intralesional injection of steroids.

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