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Factors associated with the relapse of infantile haemangiomas in children treated with oral propranolol
C K Ahogo1, K Ezzedine, S Prey
1Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Pellegrin Children's Hospital, Bordeaux, France.
Insights
Infantile haemangiomas (IHs) treated with propranolol may relapse. Segmental IHs and those with a deep component are at higher risk, suggesting closer follow-up or longer treatment is needed.
Area of Science:
- Pediatric Dermatology
- Medical Research
- Clinical Oncology
Background:
- Propranolol is the standard treatment for infantile haemangiomas (IHs).
- Factors influencing IH relapse after propranolol cessation are not well understood.
- This study addresses a gap in knowledge regarding IH recurrence risks.
Purpose of the Study:
- To identify factors associated with relapse in children with IH after oral propranolol treatment.
- To compare relapse risks among different IH subtypes and patient demographics.
- To inform clinical management and follow-up strategies for IH patients.
Main Methods:
- Retrospective observational study at a single center.
- Inclusion criteria: IH patients aged ≤5 months at treatment initiation (2008-2011).
- Data review included patient files and photographs to assess relapse.
Main Results:
- 158 children were analyzed; 40 (25%) experienced relapse.
- Multivariate analysis identified deep-component IHs and segmental IHs as independent predictors of relapse.
- No significant association found with patient sex or age at treatment initiation.
Conclusions:
- Segmental infantile haemangiomas and those with a deep component have a higher risk of relapse.
- These findings suggest a need for closer monitoring or extended treatment duration for at-risk patients.
- This research aids in optimizing post-treatment follow-up protocols for infantile haemangiomas.
Background:
Although propranolol has become the first-line therapy for infantile haemangiomas (IHs), no study has yet investigated factors associated with the risk of relapse in children with IH treated with propranolol after cessation of treatment.
Objectives:
To compare factors associated with the risk of relapse in children with IH treated with oral propranolol.
Methods:
We conducted a single-centre retrospective observational study. All files and photographs of patients with IH aged 5 months or less at the time of treatment initiation, and who were seen between 1 June 2008 and 31 December 2011 at the National Reference Center for rare skin diseases of Bordeaux, were retrospectively reviewed.
Results:
In total 158 children were included, of whom 118 had not relapsed and 40 had relapsed. Fifty-two patients were boys and 106 were girls (male : female ratio 1 : 2), and 19 had a segmental IH (12%). When conducting multivariate analysis, only IHs with a deep component and those with segmental distribution were independently associated with relapse.
Conclusions:
Our study shows that segmental IHs, as well as haemangiomas with a deeper component, are more at risk of relapse and should thus indicate closer follow-up after treatment interruption, and/or longer treatment.
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