Efficacy and safety of propranolol for the treatment of infantile hemangioma: A presentation of ninety-nine cases

Background: Propranolol is highly effective in the treatment of infantile hemangioma (IH), but important clinical and pharmacological data are lacking. Objective: The aims of the present study were to evaluate the efficacy of propranolol for the treatment of IH, to identify favorable prognostic factors in propranolol-treated IH, and to evaluate the safety of propranolol for the treatment of IH. Methods: Clinical data were recorded from the electronic files and digital photographs of 99 patients with IH attending a tertiary pediatric medical center (2008-2011). Findings were evaluated by regression in volume and color changes. Results: The male-to-female ratio was 1:4. Age at treatment initiation was 9.4 ± 10.1 months; 15% of the treated hemangiomas were beyond the proliferative phase (17-54 months). The propranolol starting dose was 2 mg/kg/day. Duration of the treatment was 8.5 ± 3.2 months. All but 1 patient responded to treatment. A longer treatment course was required for segmental and deep hemangiomas. Mild side effects occurred in 32% of patients. Recurrence occurred in 13% of patients. Conclusion: Lesions located on the face are better responders when treatment is started early. Treatment should continue up to age 12-15 months, with a longer course for segmental or deep hemangiomas.