Groot infantiel hemangioom in het gelaat

E. Burkink, Lieke van Delft, C.J.M. van der Vleuten, I.F. Nagtzaam

Research output: Contribution to journalEditorialAcademicpeer-review

Abstract

Infantile hemangiomas (IH) are the most common benign
(vascular) tumors in infancy but due to their natural selflimiting
course do not necessarily need treatment. In case
of ulceration, bleeding or potential deformity, treatment
is necessary. Large segmental facial hemangiomas may
be associated with the PHACE syndrome. We present a
case of a boy with a large segmental facial IH. Ulceration,
size and location of the IH were indications for starting
propranolol eleven days after birth up to a dose of 3 mg/
kg/day in three doses. Because of the location and distribution,
PHACE syndrome was excluded. The patient was
checked for possible brain, cardiac and vascular malformations
and visual impairment. The IH improved and at the
age of eleven months there were no adverse effects to the
propranolol or IH progression.
Propranolol is a beta blocker effective in treating IH. Its
working mechanism has not been completely clarified.
We provide a detailed description of our approach to the
early propranolol treatment for this large segmental facial
hemangioma. Complicated hemangiomas as described
here can be treated safely and effectively with propranolol.
Early treatment is recommended to prevent the development
of anatomic deformities and especially to prevent
future disfigurement when it is located in a high risk
area like the face. Further research is needed to provide
consensus and a universal guideline for the treatment of
hemangioma’s with propranolol. Complicated hemangiomas
like the one described here can be treated safely and
effectively with propranolol; very early treatment initiation
is recommended to prevent the development of anatomic
deformities. Especially in order to prevent future disfigurement
when it is located in a high risk area like the face.
Further research is needed to create a uniform approach
and universal guideline for the treatment of hemangioma
with propranolol.
Original languageDutch
Pages (from-to)585-588
Number of pages4
JournalNederlands Tijdschrift voor Dermatologie en Venereologie
Volume27
Issue number10
Publication statusPublished - Oct 2017

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