Praticò Andrea Domenico, Caraci Filippo, Pavone Piero, Falsaperla Raffaele, Drago Filippo, Ruggieri Martino
Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, Catania, Italy.
Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
Drug Saf Case Rep. 2015 Dec;2(1):6. doi: 10.1007/s40800-015-0009-1.
Infantile hemangiomas (IHs) occur in early infancy and are considered to be one of the most frequent childhood tumors. Poor responsiveness to the treatment and complications are reported in about 10 % of patients. For years, the most common treatments for cutaneous and complicated IHs were corticosteroids, interferon-α, vincristine, laser therapy, or surgical intervention. More recently, treatment with propranolol has been reported with high success rates, both in the cutaneous and complicated form of IHs, and it is now considered to be the first-line treatment for IHs. Herein we report five cases of cutaneous IHs who presented at our unit between January 2011 and June 2012: in three of five patients, the lesion improved soon after the beginning of propranolol treatment; one case presented slow but complete resolution; and in one patient the treatment was unsuccessful. Patients who do not respond to propranolol have been seldom reported in the literature. However, the failure of propranolol treatment in childhood hemangiomas has been more frequent in our experience than that reported in previous case series. More attention should be given to the cases that poorly or negatively respond to treatment, and to the mechanisms underlying the failure to respond to treatment with propranolol.
婴儿血管瘤（IHs）在婴儿早期出现，被认为是儿童期最常见的肿瘤之一。据报道，约10%的患者对治疗反应不佳且会出现并发症。多年来，治疗皮肤型和复杂型IHs最常用的方法是使用皮质类固醇、α干扰素、长春新碱、激光治疗或手术干预。最近，有报道称普萘洛尔治疗皮肤型和复杂型IHs的成功率很高，现在它被认为是IHs的一线治疗方法。在此，我们报告2011年1月至2012年6月期间在我院就诊的5例皮肤型IHs病例：5例患者中有3例在开始使用普萘洛尔治疗后不久病变就有所改善；1例病例病变消退缓慢但最终完全消退；还有1例患者治疗未成功。文献中很少报道对普萘洛尔无反应的患者。然而，根据我们的经验，儿童血管瘤普萘洛尔治疗失败的情况比以往病例系列报道的更为常见。对于治疗反应不佳或无反应的病例以及普萘洛尔治疗失败的潜在机制，应给予更多关注。
