Infantile hemangioma. Part 2: Management - 18/11/21
, Ana l. Rodríguez Bandera, MD, PhD a, Li-Chuen F. Wong, MD, MM, DCH a, Orli Wargon, MBBS (Hons), MClinEd cAbstract |
The majority of infantile hemangiomas (IH) can be managed conservatively, but for those requiring active treatment, management has been revolutionized in the last decade by the discovery of propranolol. Patients that may require active intervention should receive specialist review, ideally before 5 weeks of age to mitigate the risk of sequelae. Propranolol can commence for most infants in the outpatient setting and the most frequently employed dosing regimen is 1 mg/kg twice daily. In the future, β-blockers with a more-selective mechanism of action, such as atenolol, show some promise. In recalcitrant lesions, systemic corticosteroids or sirolimus may be considered. For small, superficial IHs, topical timolol maleate or pulsed dye laser may be considered. Where the IH involutes with cutaneous sequelae, a range of interventions have been reported, including surgery, laser, and embolization. IHs have a well-described clinical trajectory and are readily diagnosed and managed via telemedicine. Algorithms have been constructed to stratify those patients who can be managed remotely from those who warrant in-person review during the COVID-19 pandemic.
Le texte complet de cet article est disponible en PDF.Key words : hemangioma, vascular malformation, nevus, propranolol, laser, pediatric dermatology
Abbreviations used : IH, PDL, PHACES
Plan
| Funding sources: None. |
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| Date of release: December 2021. |
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| Expiration date: December 2024. |
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| IRB approval status: Not applicable. |
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| Reprints not available from the authors. |
Vol 85 - N° 6
P. 1395-1404 - décembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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