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Infantile Hemangiomas Cleared by Combined Therapy With Pulsed Dye Laser and Propranolol
Atsuko Sugimoto1,2, Ritsu Aoki1,2, Eri Toyohara1,2
1Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, Tokyo, Japan.
Insights
Combining propranolol with pulsed dye laser (PDL) therapy may shorten infantile hemangioma treatment duration. This combined approach appears to reduce the need for prolonged propranolol use without increasing adverse effects, offering a potentially more efficient treatment strategy.
Area of Science:
- Dermatology
- Pediatrics
- Medical Technology
Background:
- Oral propranolol is the standard first-line treatment for infantile hemangioma.
- Combining propranolol with pulsed dye laser (PDL) may offer benefits in treatment duration and outcomes.
Purpose of the Study:
- To evaluate the impact of PDL-propranolol combination therapy on the duration of treatment and the incidence/severity of sequelae in infantile hemangioma.
Main Methods:
- Retrospective analysis of consecutive infantile hemangioma patients treated with PDL and propranolol.
- Patients received standardized PDL sessions and oral propranolol, with dosage adjusted based on clinical response and contraindications.
Main Results:
- The study included 27 patients with a mean age of 4.3 months at treatment initiation.
- Average treatment duration with propranolol was 11.1 months, and total treatment duration was 15.3 months.
- Tumor-type infantile hemangiomas were most common (72.4%).
Conclusions:
- Combining propranolol with PDL treatment for infantile hemangioma may reduce the required duration of propranolol therapy.
- This combined approach suggests a potential for reduced treatment duration without an increase in adverse events.
Background:
Oral propranolol is the first-line therapy for infantile hemangioma. Combining it with pulse dye laser (PDL) (595nm-long PDL) could reduce treatment duration and sequelae incidence and severity.
Objective:
To determine the effect of PDL-propranolol treatment on duration to cure and sequelae.
Methods:
All consecutive patients with infantile hemangioma who were cured by PDL-propranolol treatment were identified.
Results:
In the 27 cases, average age at treatment start was 4.3 ± 3.8 months, mean tumor diameter was 11.1 ± 14.0 cm2, and tumor-type was most common (72.4% of lesions). The patients received 9.8 ± 10.5 PDL sessions. After ensuring patients had no physical contraindications, including heart disease, oral propranolol was started at 1 mg/kg/d, increased up to 3 mg/kg/d as a maintenance dose. Mean propranolol treatment duration was 11.1 ± 4.9 months. Total treatment duration was 15.3 ± 10.8 months.
Conclusion:
Our data in the context of recent literature suggest combining propranolol with PDL may reduce propranolol duration without increasing harms.
