Hong Esther, Fischer Gayle
Department of Dermatology, Royal North Shore Hospital, Sydney, NSW, Australia.
Pediatr Dermatol. 2012 Jan-Feb;29(1):64-7. doi: 10.1111/j.1525-1470.2011.01547.x. Epub 2011 Aug 19.
Hemangioma of infancy (HOI) is a common, self-resolving, benign tumor that frequently requires no intervention. Ulceration is one of the main complications of HOI, and active treatment is usually required to manage pain, potential scarring, and occasionally bleeding and infection. Since the discovery that oral propranolol is an effective treatment for complicated HOI, it has been replacing systemic corticosteroids as first-line therapy, and early recommendations for treatment protocols have been devised. We report the successful treatment of six children with recalcitrant ulcerated HOI using propranolol. In all cases, complete, rapid healing occurred. Two children experienced recurrence of ulceration after ceasing propranolol, but this was rapidly controlled by restarting treatment. No adverse effects were encountered. We propose that ulceration in HOI is an indication for propranolol treatment if more conservative therapies have failed.
婴儿血管瘤（HOI）是一种常见的、可自行消退的良性肿瘤，通常无需干预。溃疡是HOI的主要并发症之一，通常需要积极治疗以控制疼痛、预防潜在的瘢痕形成，以及偶尔出现的出血和感染。自从发现口服普萘洛尔是治疗复杂HOI的有效方法以来，它已逐渐取代全身用皮质类固醇成为一线治疗药物，并且已经制定了早期治疗方案的建议。我们报告了使用普萘洛尔成功治疗6例顽固性溃疡型HOI患儿的病例。在所有病例中，溃疡均完全、迅速愈合。2例患儿在停用普萘洛尔后溃疡复发，但重新开始治疗后迅速得到控制。未出现不良反应。我们建议，如果更保守的治疗方法失败，HOI中的溃疡是使用普萘洛尔治疗的指征。
