RT Journal
A1 Price CJ, Lattouf C, Baum B, et al
T1 Propranolol vs corticosteroids for infantile hemangiomas: A multicenter retrospective analysis
JF Archives of Dermatology
JO Archives of Dermatology
YR 2011
FD December 1
VO 147
IS 12
SP 1371
OP 1376
DO 10.1001/archdermatol.2011.203
UL http://dx.doi.org/10.1001/archdermatol.2011.203
AB Objective 
                  To determine whether propranolol therapy is safe and effective and superior to oral corticosteroids for treating infantile hemangiomas (IHs).Design 
                  Multicenter retrospective chart review.Setting 
                  University of Miami and Miami Children's Hospital, Miami, Florida.Patients 
                  The study included 110 patients with IHs.Main Outcome Measures 
                  The percentage of clearance was quantified by documented serial global photography and clinical examinations (length, height, and width) to segregate patients into 2 groups: patients who had clearance of 75% or more and patients who had less than 75% clearance.Results 
                  The mean duration of treatment was 7.9 months for propranolol and 5.2 months for oral corticosteroids. Fifty-six of 68 patients (82%) who were receiving propranolol achieved clearance of 75% or more compared with 12 of 42 patients (29%) who were receiving oral corticosteroids (P   <  .01). Adverse effects were minimal in the propranolol group: 1 patient had hypoglycemia and 2 patients had a nonspecifice skin eruption that was not associated with propranolol therapy. All 42 patients in the corticosteroid group had 1 or more adverse effects (P   <  .01). Relapse after discontinuation of propranolol therapy occurred in 2 of the 68 patients; however, both patients responded to propranolol therapy on reinitiation of treatment. Surgical referrals after treatment were required in 8 patients (12%) in the propranolol group and 12 patients (29%) in the oral corticosteroid group (P   <  .01).Conclusions 
                  Propranolol therapy was more clinically effective and more cost-effective than oral corticosteroids in treating IHs. It also resulted in fewer surgical interventions and demonstrated better tolerance, with minimal adverse effects, compared with oral corticosteroids. Therefore, propranolol should be considered a first-line agent given its safety and efficacy in the treatment of IHs.