[Treatment of haemangiomas of infancy with propranolol; good results, few side effects]

Denise J J Hermans1, Maarten J Ottenhof, Marc H W A Wijnen

  • 1Universitair Medisch Centrum St. Radboud, Afd. Dermatologie, Nijmegen, the Netherlands. d.hermans@derma.umcn.nl

Infantile haemangiomas (IH) are the most commonly occurring benign tumours of infancy, which may lead to considerable morbidity, such as amblyopia, ulceration and airway obstruction, depending on localization. Until recently, treatment was difficult: high-dose systemic glucocorticoids had limited effect and serious side effects. In 2008, the effectiveness of the beta-blocker propranolol for infantile haemangiomas was discovered; by now there is extensive worldwide experience. Data from the literature and from our own patient cohort (n = 132) confirm the remarkable efficacy of propranolol in complicated IH, without significant adverse effects. Propranolol is most effective in the proliferation phase of IH in children under 6 months of age. Timely referral of patients with potentially function-threatening or life-changing IH to a specialised multidisciplinary centre is therefore essential. Pending controlled studies, propranolol appears to have become the first choice treatment in complicated IH.

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