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The treatment of problematic hemangiomas in children with propranolol and 940nm diode laser
Nataliia Dementieva1, Sarah Jones2
1Department of pediatric surgery, Dnepropetrovsk' Regional Pediatric Hospital, Ukraine.
Insights
Systemic propranolol (Pr) therapy combined with laser treatment effectively reduces infantile hemangiomas (IH) in children. This combination therapy offers a safe and cosmetically superior outcome for IH compared to Pr therapy alone.
Area of Science:
- Dermatology
- Pediatrics
- Laser Medicine
Background:
- Hemangiomas are prevalent pediatric skin lesions, affecting 10-12% of infants.
- Infantile hemangiomas (IH) can cause significant cosmetic and functional concerns.
Purpose of the Study:
- To evaluate the efficacy and safety of systemic propranolol (Pr) combined with 940nm diode laser therapy for severe hemangiomas.
- To assess the added benefit of laser therapy after propranolol treatment for infantile hemangiomas.
Main Methods:
- 123 patients (112 with IH, 11 with vascular malformations) received systemic Pr therapy (2-2.5mg/kg/day for 6-8 months).
- Patients with residual IH lesions (n=61) underwent subsequent 940nm diode laser photothermolysis.
- Outcomes measured included volume, color, and adverse events.
Main Results:
- Propranolol therapy showed no effect on vascular malformations but reduced IH volume and color.
- Laser therapy further improved IH appearance, achieving 0% residual volume in 84% of patients.
- 89% of patients experienced a 0-20% residual color intensity post-laser treatment.
- No adverse events were reported with laser therapy.
Conclusions:
- Combining laser therapy with systemic propranolol is a safe and effective treatment for infantile hemangiomas.
- This combination therapy yields excellent cosmetic results for pediatric hemangiomas.
- Laser therapy complements propranolol treatment, offering significant improvement for residual IH lesions.
Background:
Hemangiomas are common skin lesion, affecting 10-12% of children <1year of age. The purpose of this study was to determine the effect and safety of systemic propranolol (Pr) therapy in combination with 940nm diode laser for the treatment of severe hemangiomas.
Methods:
Patients (123: 11 with vascular malformations and 112 with infantile hemangiomas (IH)) were enrolled in the study. They were initially treated with: systemic Pr therapy (2-2.5mg/kg/day) for 6-8months. Following completion of Pr therapy, patients with significant residual lesions (n-61) were treated with photothermolysis (laser therapy).
Results:
Pr therapy had no effect on the color and volume of the vascular malformations. Pr therapy alone demonstrated a reduction in both volume and color of the IH. Laser therapy resulted in a continued improvement in the appearance of the IH with 84% of patients experiencing a residual volume of 0% compared to the original and 89% experiencing a decrease to between 0 and 20% of original color. There were no adverse events associated with laser therapy.
Conclusions:
This study demonstrates that the addition of laser therapy to Pr therapy for the treatment of IH in children is well tolerated with a very acceptable cosmetic result.
