dermatologic disorders
Infantile Hemangiomas
Treatment of Infantile Hemangiomas
Individualized based on location, size, and severity of lesions For superficial or uncomplicated lesions that require treatment, possibly topical or intralesional corticosteroids or topical beta-blockers ( Treatment references ) ( Treatment references ) General wound care for ulcerated lesions Usually avoidance of surgery There is no universal infantile hemangioma treatment recommendation. Because most lesions resolve spontaneously, observation is usually indicated before initiating treatment. Treatment should be considered for complicated or high-risk lesions, ie, those that Threaten life Threaten function (eg, vision) Involve large areas of the face Are distributed over the beard area Are ulcerated Are multiple Are lumbosacral Topical treatments and wound care are useful for ulcerated lesions and help prevent scarring, bleeding, and pain. Compresses, topicalmupirocinormetronidazole, barrier dressings (generally polyurethane film dressing or petrolatum-impregnated gauze), or barrier creams may be used to prevent infection and/or reduce colonization. Unless complications are life threatening or vital organs are compromised, surgical excision or other destructive procedures should be avoided because they frequently cause more scarring than occurs with spontaneous involution. To help parents accept nonintervention, the physician can review the natural history (photographic examples are helpful), provide serial photography of the lesion to document involution, and listen sympathetically to parents’ concerns. 1.Boos MD, Castelo-Soccio: Experience with topicaltimololmaleate for the treatment of ulcerated infantile hemangiomas (IH).J Am Acad Dermatol74(3):567-570, 2016. doi: 10.1016/j.jaad.2015.10.021 2.Hogeling M, Adams S, Wargon O: A randomized controlled trial ofpropranololfor infantile hemangiomas.Pediatrics128(2):e259-266, 2011. doi: 10.1542/peds.2010-0029 