Infantile hemangiomas.
Current treatment procedures

Česká verzia

Authors: J. Mališ ¹; V. Stará ²; K. Bláhová ²; H. Bučková ³; R. Faberová ³; J. Štěrba ⁴; S. Klovrzová ⁵; M. Kynčl ⁶; Michal Černý ⁷ ; R. Hrdlička ⁸ ; M. Mojžíšová ⁹; M. Vaculík ¹⁰; J. Kozák ¹⁰; R. Katra ¹¹; I. Michalusová ¹²; A. Sukop ¹³; M. Rygl ¹⁴; J. Hercogová ¹⁵; P. Arenberger ¹⁶; R. Šmucler ¹⁷; Š. Čapková ¹⁸
Authors place of work: Klinika dětské hematologie a onkologie 2. LF UK a FN Motol, Praha ¹; Pediatrická klinika 2. LF UK a FN Motol, Praha ²; Dětské kožní oddělení Pediatrické kliniky FN Brno ³; Klinika dětské onkologie LF MU a FN Brno ⁴; Nemocniční lékárna FN Motol, Praha ⁵; Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha ⁶; Novorozenecké oddělení Gynekologicko-porodnické kliniky 2. LF UK a FN Motol, Praha ⁷; Dětské oddělení nemocnice, Kolín ⁸; Dětské oddělení nemocnice, Hořovice ⁹; Neurochirurgická klinika dětí a dospělých 2. LF UK a FN Motol, Praha ¹⁰; Klinika ušní, nosní a krční 2. LF UK a FN Motol, Praha ¹¹; Stomatologická klinika dětí a dospělých 2. LF UK a FN Motol, Praha ¹²; Klinika plastické chirurgie 3. LF UK a FN Královské Vinohrady, Praha ¹³; Klinika dětské chirurgie 2. LF UK a FN Motol, Praha ¹⁴; Dermatovenerologická klinika 2. LF UK a Nemocnice Na Bulovce, Praha ¹⁵; Dermatovenerologická klinika 3. LF UK a FN Královské Vinohrady, Praha ¹⁶; Asklepion, Praha ¹⁷; Dermatologické oddělení pro děti, FN Motol, Praha ¹⁸
Published in the journal: Čes-slov Pediat 2017; 72 (4): 245-254.
Category:

Summary

Infantile hemangiomas are the most common benign tumors that affect between 10–12% 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 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 should be performed in centers where a pediatric dermatologist, oncologist, cardiologist, radiologist, and surgeon are provided with the appropriate specializations to resolve residual lesions.

KEY WORDS:
hemangioma, infantile hemangioma, propranolol

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