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1Unité de dermatologie pédiatrique et centre de référence des maladies rares de la peau, hôpital Pellegrin-Enfants, CHU de Bordeaux, 33076 Bordeaux Cedex, France.
Annales De Dermatologie Et De Venereologie
|February 13, 2018
Summary
Propranolol is a safe and effective treatment for infantile hemangiomas, with long-term safety data showing no unexpected side effects. Topical timolol, however, requires caution due to potential systemic absorption and adverse events in infants.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
- Atopic Dermatitis
- Infectious Diseases
Background:
- Infantile hemangiomas (IH) are associated with syndromes like PHACE and LUMBAR.
- Propranolol is effective for IH, but safety concerns persist.
- Topical beta-blockers for IH show systemic absorption risks.
- mTOR inhibitors are being explored for vascular malformations.
- Skin barrier defects contribute to atopic dermatitis and sensitization.
- Viral outbreaks cause dermatological manifestations and neurological complications.
Purpose of the Study:
- To review current therapeutic options and emerging research in pediatric dermatology.
- To highlight safety considerations for established and novel treatments.
- To discuss advancements in understanding pathophysiology and future targeted therapies.
Main Methods:
- Literature review of recent studies on infantile hemangiomas, vascular malformations, atopic dermatitis, and infectious dermatoses.
- Analysis of safety data for propranolol and topical timolol.
- Evaluation of emerging treatments like mTOR inhibitors and crisaborole.
- Discussion of genetic advancements and viral outbreak impacts.
Main Results:
- Propranolol demonstrates a favorable long-term safety profile in thousands of children.
- Topical timolol carries risks of systemic absorption and adverse effects (e.g., bradycardia) in low-birthweight infants.
- mTOR inhibitors show variable success in vascular malformations.
- Crisaborole offers limited efficacy in pediatric atopic dermatitis, comparable to emollients.
- Viral infections like Zika and enteroviruses present significant dermatological and neurological challenges.
Conclusions:
- Propranolol remains a cornerstone therapy for infantile hemangiomas with proven safety.
- Cautious use of topical timolol is advised due to systemic absorption risks.
- Further research is needed for mTOR inhibitors in vascular malformations.
- Targeted therapies based on genetic insights hold future promise.
- Management of viral-induced dermatoses requires ongoing vigilance.