Abstract
Infantile hemangiomas (IH) are the most common benign tumors affecting 10-12% of infants with increased incidence in premature and immature female babies. There are three basic types - superficial, deep and mixed.
Infantile hemangiomas are the result of vasculogenesis and angiogenesis dysregulation. IH differ in number, size and depth of skin and subcutaneous tissue invasion.
Most hemangiomas (90%) do not require treatment, involution lasting several years occurs after intense growth phase in the first 5 to 6 months of life. In extensive segmental and deep hemagiomas growth activity persists even in the 2nd and 3rd year of life.
Approximately 10 % of IH might cause serious complications. Treatment choice is individual and requires comprehensive approach.
The choice is the non-selective betablocker propranolol administered at a dose of 2-3mg/kg/day for 6-7 months. Propranolol acts as a vasoconstrictor of IH capillaries, blocks vascular endothelial growth factor (VEGF) promoting vascular development and induces apoptosis (natural death of vascular cells).
Treatment has to be performed in centres with experienced pediatric dermatologist, oncologist, cardiologist, radiologist and plastic surgeon. Propranolol treatment is reimbursed in 4 centres in the Czech Republic (Faculty Hospitals in Motol, Královské Vinohrady, Brno and Ostrava).