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Infantile periocular haemangioma treated with two days in a week betamethasone oral mini pulse therapy
1Department of Ophthalmology, Lady Hardinge Medical College. All India Institute of Medical Sciences, New Delhi. kkverma61@hotmail.com
Insights
Oral betamethasone effectively treated a large facial capillary hemangioma in an infant. This treatment rapidly reduced the lesion size, improving vision by clearing the eyelid obstruction.
Area of Science:
- Dermatology
- Pediatric Ophthalmology
Background:
- Infantile capillary hemangiomas are common benign vascular tumors.
- Large facial hemangiomas can cause significant functional impairment, such as visual axis obstruction.
Observation:
- A one-month-old male infant presented with a large, asymptomatic, bright red facial plaque.
- The lesion measured 12 cm x 10 cm, involving the forehead and right upper eyelid, obscuring the visual axis.
Findings:
- Computed tomography confirmed a capillary hemangioma.
- Treatment with oral betamethasone (2 mg twice weekly) resulted in 80% reduction in lesion size within six weeks.
- Over 90% improvement was noted after twelve weeks, with significant visual axis clearing.
Implications:
- Oral betamethasone is an effective treatment for large infantile capillary hemangiomas causing functional impairment.
- Early intervention can prevent long-term complications and improve visual outcomes.
- This case highlights the successful management of a visually significant facial vascular anomaly.
Abstract:
A one-month-old male infant had a large asymptomatic, bright red swelling on the face with inability to open his right eye since birth. On cutaneous examination there was a large brightly erythematous, lobulated, soft plaque on the right side of the forehead of 12 cm x 10 cm, involving the right upper eyelid obscuring the visual axis and extending on to the right upper lip. Ocular examination revealed normal anterior and posterior segments. Computed tomography of head and orbit confirmed the diagnosis of capillary haemangioma. The child was treated with oral betamethasone 2 mg as the signal daily dose on the two consecutive days in a week. After six weeks there was 80% reduction in the size of the lesion and the right upper eyelid almost completely cleared the visual axis. In another six weeks, the improvement was more than 90%.
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