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How to use bleomycin A5 for infantile maxillofacial haemangiomas: clinical evaluation of 82 consecutive cases
1Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, #22 Zhongguancun Nandajie, Haidian District, Beijing, PR China. lqf6668@163.com
Objective:
Bleomycin A5 has been reported effective for infantile haemangioma (IH), but the usage and complications were described a little. We have used bleomycin A5 to treat maxillofacial IHs for 15 years. This paper describes the procedures to use bleomycin A5 and avoid its complications based on our clinical practices.
Methods:
Bleomycin A5 (8mg, powder) was mixed with 2% lidocaine (3ml) and dexamethasone (1ml, 5mg), the mixture concentration is 2mg/ml (bleomycin A5). The drug was given by multiple intralesional injections, with the dosage calculated according to the age of the patient and size of the lesion. Cautions were paid to the drug dosage and concentration, as well as the depth of injection. The patients were also given oral prednisone (2-5mg/kg every other day) during proliferating stage.
Results:
After treatment with bleomycin A5 in appropriate quantity and concentration, injecting depth, all haemangiomas involuted completely, with smaller lesions showing better recovery of skin colour and less scar formation, and no serious side effects happened.
Conclusion:
Bleomycin A5 is an effective treatment for IHs. Oral prednisone is necessary for patients at proliferating stage.
Insights
Bleomycin A5 effectively treats infantile haemangiomas (IH) with proper technique, leading to complete involution. Oral prednisone is crucial for patients in the proliferating stage to minimize complications.
Area of Science:
- Dermatology
- Pediatric Medicine
- Pharmacology
Background:
- Infantile haemangioma (IH) is a common pediatric vascular tumor.
- Bleomycin A5 has shown efficacy in treating IH, but detailed usage and complication data are limited.
Purpose of the Study:
- To describe the clinical procedures for using bleomycin A5 in treating maxillofacial infantile haemangiomas.
- To outline methods for avoiding complications associated with bleomycin A5 treatment.
Main Methods:
- Bleomycin A5 was prepared at a concentration of 2mg/ml with lidocaine and dexamethasone.
- Multiple intralesional injections were administered, with dosage adjusted for patient age and lesion size.
- Careful attention was paid to drug concentration, dosage, and injection depth; oral prednisone was given during the proliferating stage.
Main Results:
- Complete involution of infantile haemangiomas was achieved with appropriate bleomycin A5 treatment.
- Smaller lesions demonstrated better skin color recovery and reduced scarring.
- No serious adverse events were reported.
Conclusions:
- Bleomycin A5 is a highly effective treatment for infantile haemangiomas.
- Concurrent oral prednisone administration is essential for patients with proliferating-stage IH.
