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Infantile Haemangiomas: A Dermatologist's Perspective

Publication at Second Faculty of Medicine, Third Faculty of Medicine |
2017

Abstract

Infantile hemangiomas are the most common benign tumors that affect between 10% and 12% of infants, a higher incidence in premature and immature children. There are three basic types - superficial, deep and mixed.

Most hemangiomas do not require any treatment, stagnation and involution occur after the phase of intense growth in the first 4 to 5 months of life. About half of the hemangiomas persist in more or less significant residues.

Around 10% of hemangiomas can cause serious complications - endangering vital functions (eyelid, nose, etc.), exudation, bleeding and severe cosmetic impairment. The first-line drug, in the present, is the non-selective betablocker propranolol administered at a dose of 2-3 mg/kg /day for 6 months.

Propranolol acts as a vasoconstrictor of capillary hemangiomas, blocking vascular endothelial growth factor (VEGF) promoting vascular development and promoting apoptosis (natural death of vascular cells). Propranolol induces involution of hemangioma and residues after treatment are significantly lower and less severe.

The most common complications are sleep disorder (up to 20% of children). Treatment using Hemangiol (propranolol) has been reimbused in 4 centres in the Czech Republic (FN Motol, FN Královské Vinohrady, FN Brno and FN Ostrava).