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Practice Variations in Managing Infantile Hemangiomas.

Thomas W McLean1, Alexandra J Borst2, Adrienne M Hammill3

  • 1Vascular Anomalies Special Interest Group of the American Society of Pediatric Hematology/Oncology and the Divisions of Pediatric Hematology/Oncology, Wake Forest University School of Medicine, Winston-Salem.

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|September 26, 2023
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Summary
This summary is machine-generated.

Management of infantile hemangioma (IH) varies widely among clinicians. This study highlights inconsistencies in treatment approaches for IH, emphasizing the need for updated, evidence-based guidelines to ensure optimal patient care.

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Area of Science:

  • Pediatric Dermatology
  • Vascular Anomalies
  • Clinical Practice Variations

Background:

  • Infantile hemangioma (IH) is the most common pediatric tumor.
  • Beta blockers, particularly propranolol, are standard treatment for IH.
  • Existing guidelines do not fully address all clinical management questions.

Purpose of the Study:

  • To document current clinical practice variations in IH management.
  • To identify areas requiring further research and guideline development.
  • To assess provider approaches to IH treatment.

Main Methods:

  • An internet-based survey was distributed to clinicians treating IH.
  • Hypothetical clinical cases and management scenarios were presented.
  • Data on treatment strategies, dosing, duration, and follow-up were collected.

Main Results:

  • Significant variations exist in patient selection for treatment, optimal dosing, and duration of propranolol therapy.
  • Practices differ regarding patient monitoring, need for additional workup, and propranolol discontinuation.
  • Most respondents use generic propranolol (2 mg/kg/d) for head and neck IH until approximately one year of age.

Conclusions:

  • Wide practice variations in infantile hemangioma management persist among clinicians.
  • Further research is necessary to address these inconsistencies.
  • Development of updated, evidence-based guidelines is crucial for standardized IH care.