Chang Chun-Shin, Kang Gavin Chun-Wui
Department of Plastic & Reconstructive Surgery, Craniofacial Research Center, Craniofacial Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Chemical and Materials Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan; and Department of Plastic, Reconstructive, and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore, Singapore.
Plast Reconstr Surg Glob Open. 2016 Feb 16;4(2):e621. doi: 10.1097/GOX.0000000000000605. eCollection 2016 Feb.
Infantile hemangiomas (IHs) are the most common benign pediatric soft-tissue tumors. Ulceration-the most frequent complication of IH-tends to heal poorly and is associated with pain, bleeding, infection, and scarring. Mainstay treatment modalities include propranolol (β-blocker) and corticosteroids, whose effectiveness is countered by a need for long-term medication and risk of systemic adverse effects and ulcer recurrence. A 3-month-old infant presented to us with a large, medial thigh-ulcerated IH that progressed despite 2 prior months of dressings and topical antimicrobials. Topical timolol 0.5% thrice daily was initiated, and significant healing was evident at 1 week, with complete healing at 1 month. Timolol was stopped after 3 months, and at 18 months after cessation of timolol, there was no ulcer recurrence. This novel therapy for ulcerated IH seems to have many advantages such as rapid efficacy with easy application, no systemic adverse effects and no long-term recurrence, and current literature describing similar advantages justifies the use of this treatment modality in infants.
婴儿血管瘤（IHs）是最常见的小儿良性软组织肿瘤。溃疡是IH最常见的并发症，愈合往往较差，且与疼痛、出血、感染和瘢痕形成有关。主要治疗方式包括普萘洛尔（β受体阻滞剂）和皮质类固醇，但由于需要长期用药以及存在全身不良反应和溃疡复发风险，其有效性受到影响。一名3个月大的婴儿因大腿内侧有一个巨大的溃疡型IH前来就诊，尽管此前两个月一直进行敷料和局部抗菌治疗，但病情仍有进展。开始每天三次外用0.5%噻吗洛尔，1周时明显愈合，1个月时完全愈合。3个月后停用噻吗洛尔，在停用噻吗洛尔18个月后，溃疡未复发。这种针对溃疡型IH的新疗法似乎有许多优点，如疗效迅速、应用简便、无全身不良反应且无长期复发，目前描述类似优点的文献证明了这种治疗方式在婴儿中的应用合理性。
