Systemic corticosteroids in infantile hemangioma

Nootchanard Mahamaytakit; Srisupalak Singalavanija; Wanida Limpongsanurak

Authors

Nootchanard Mahamaytakit DIVISION OF DERMATOLOGY, QUEEN SIRIKIT NATIONAL INSTITUTE OF CHILD HEALTH, BANGKOK, THAILAND
Srisupalak Singalavanija DIVISION OF DERMATOLOGY, QUEEN SIRIKIT NATIONAL INSTITUTE OF CHILD HEALTH, BANGKOK, THAILAND
Wanida Limpongsanurak DIVISION OF DERMATOLOGY, QUEEN SIRIKIT NATIONAL INSTITUTE OF CHILD HEALTH, BANGKOK, THAILAND

Keywords:

infantile hemangioma, systemic corticosteroids

Abstract

Backgrounds: Infantile Hemangioma (IH) is the most common vascular tumor of infancy. Traditionally, corticosteroids are the drug of choice for complicated hemangioma.

Objective: To determine efficacy and side effects of systemic corticosteroids in complicated IH.

Materials and Methods: We reviewed clinical, dose, duration, outcome and side effects of systemic corticosteroids and follow-up data of 109 patients with complicated IH at Queen Sirikit National Institute of Child Health over 5-year periods (2006-2011).

Results: The median age of onset of IH was 15 days (range 0-90 days). Female to male ratio was 1.8:1. Systemic corticosteroids were given due to life threatening (69.7%), cosmetics disfigure (10.1%) and ulceration (20.2%). The cutaneous sites (90 cases) were head and neck in 71.5%, extremities (6.4%), trunk (2.7%) and genitalia (1.8%). The extra cutaneous sites (19 cases) were subglottic area (7.3%), parotid area (5.5%) and hepatic area (4.5%). The median age of starting systemic corticosteroids was 3 months. Mean initial dose of prednisolone in cutaneous hemangioma was 1.58 ± 0.7 mg/kg/day and extracutaneous was 2.3 ± 1mg/kg/day. Median initial dose duration was 45 days and mean total duration of therapy was 5.3 ± 2.8 months. We found regression on all cases after initial dose. During dose tapering, 95 cases (87.2%) regressed, 7 cases (6.4%) remained stable and rebound growth in 7 cases (6.4%). Mean follow-up was 30.6 months. There were no serious side effects.

Conclusion: Systemic corticosteroids are still good options for hemangioma treatment. The management strategy should be individualized for each case.

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