Propranolol is more effective than pulsed dye laser and cryosurgery for infantile hemangiomas

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• 作者：Shinji Kagami (1) (2)
  Yoshihiro Kuwano (1)
  Sayaka Shibata (1)
  Yuta Uwajima (1)
  Daisuke Yamada (1)
  Akie Miyamoto (1)
  Takuya Miyagawa (1)
  Mayuko Araki (1)
  Kohji Takahashi (1)
  Sayako Isomura (1)
  Naohiko Aozasa (1)
  Yuri Masui (1)
  Mizuho Yamamoto (1)
  Ryo Inuzuka (3)
  Tatsuo Katori (3)
  Shinichi Sato (1)
  
• 关键词：Cryosurgery ; Infantile hemangiomas ; Laser ; Propranolol
• 刊名：European Journal of Pediatrics
• 出版年：2013
• 出版时间：November 2013
• 年：2013
• 卷：172
• 期：11
• 页码：1521-1526
• 全文大小：
• 作者单位：Shinji Kagami (1) (2)
  Yoshihiro Kuwano (1)
  Sayaka Shibata (1)
  Yuta Uwajima (1)
  Daisuke Yamada (1)
  Akie Miyamoto (1)
  Takuya Miyagawa (1)
  Mayuko Araki (1)
  Kohji Takahashi (1)
  Sayako Isomura (1)
  Naohiko Aozasa (1)
  Yuri Masui (1)
  Mizuho Yamamoto (1)
  Ryo Inuzuka (3)
  Tatsuo Katori (3)
  Shinichi Sato (1)
  
  1. Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
  2. Department of Dermatology, Kanto Central Hospital, 6-25-1 Kamiyoga, Setagaya-ku, Tokyo, 158-8531, Japan
  3. Department of Pediatrics, Faculty of Medicine, University of Tokyo, Tokyo, Japan
  
• ISSN：1432-1076

文摘

Propranolol hydrochloride is a nonselective blocker that is used for the treatment of hypertension, arrhythmia, and angina pectoris. In Japan, it was recently approved for the treatment of childhood arrhythmia. It has been observed to produce drastic involution of infantile hemangiomas. The aim of this prospective study was to examine propranolol superiority to classical therapy with pulsed dye laser and/or cryosurgery in treating proliferating infantile hemangiomas. Fifteen patients between the ages of 1 and 4months with proliferating infantile hemangiomas received grinded propranolol tablets 2mg/kg per day divided in three doses. Twelve patients with proliferating infantile hemangiomas receiving pulsed dye laser and/or cryosurgery were enrolled as controls. Baseline electrocardiogram, echocardiogram, and chest x-ray were performed. Monitoring of heart rate, blood pressure, and blood glucose was performed every 2weeks. Efficacy was assessed by performing blinded volume measurements and taking photographs at every visit. Propranolol induced significantly earlier involution and redness reduction of infantile hemangiomas, compared to pulsed dye laser and cryosurgery. Adverse effects such as hypoglycemia, hypotension, or bradycardia did not occur. Conclusion: The dramatic response of infantile hemangiomas to propranolol and few side effects suggest that early treatment of infantile hemangiomas could result in decreased disfigurement. Propranolol should be considered as a first-line treatment of infantile hemangiomas.