Colmenero-Sendra M, Del Boz-González J, Baselga Torres E, Bernabéu-Wittel J, Roé-Crespo E, Vicente A, Valdivieso-Ramos M, Martín-Santiago A, Palencia-Pérez S I, Montserrat-García M T, Azón-Masoliver A, Dañino M, Tubau Prims C, Prat C, Giacaman A, Domínguez-Cruz J J, Bauzá Alonso A, Grau-Pérez M, Descalzo M Á, García-Doval I
Dermatology Department, Hospital Costa del Sol, Marbella, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Spain.
Dermatology Department, Hospital Regional Universitario de Málaga, Spain.
Actas Dermosifiliogr. 2025 Apr;116(4):327-336. doi: 10.1016/j.ad.2024.06.010. Epub 2024 Jul 18.
Functional impairment is the main consideration when it comes to choosing therapy for infantile hemangiomas (IH). However, since most hemangiomas are treated for cosmetic reasons, it is important to know the cosmetic outcome assessed by the parents.
To evaluate the aesthetic outcomes of IH, considering the characteristics of the lesions and the treatments used.
The Spanish Infantile Hemangioma Nationwide Prospective Cohort (2016-2022) recruited all consecutive patients diagnosed with IH in 12 Spanish hospitals. The children included had two photos of the IH lesion (at both baseline and at the end of the study). A panel of parents blindly assessed all available photos using a scale from 0 (worst cosmetic outcomes) to 10 (best cosmetic outcomes). The different scores - both before and after treatment - as well as the outcomes percent considered excellent (>9) were described and compared. We analyzed the effect of receiving different therapies and performed causal model analyses estimating the mean treatment effect of parents' assessments.
The median follow-up was 3.1 years. A total of 824 photos were evaluated. Baseline aesthetic impact was higher in the propranolol group vs the topical timolol and observation treatment groups (1.85 vs 3.14 vs 3.66 respectively; p<0.001). After treatment, the aesthetic impact was similar between both treatment groups (7.59 vs 7.93 vs 7.90; p>0.2). The causal model could only be applied to the comparison between topical timolol and observation, revealing no differences whatsoever.
This is the first prospective cohort to analyze the aesthetic outcome of IH. The final aesthetic results of the three therapies were similar, with nearly 40% of patients achieving excellent aesthetic outcomes.
在选择婴儿血管瘤（IH）的治疗方法时，功能损害是主要考虑因素。然而，由于大多数血管瘤是出于美容原因进行治疗的，了解家长评估的美容效果很重要。
考虑病变特征和所用治疗方法，评估婴儿血管瘤的美学效果。
西班牙全国婴儿血管瘤前瞻性队列研究（2016 - 2022年）招募了西班牙12家医院中所有连续诊断为婴儿血管瘤的患者。纳入的儿童有两张婴儿血管瘤病变的照片（基线时和研究结束时）。一组家长使用从0（最差美容效果）到10（最佳美容效果）的量表对所有可用照片进行盲评。描述并比较了治疗前后的不同评分以及被认为优秀（>9）的结果百分比。我们分析了接受不同治疗的效果，并进行因果模型分析以估计家长评估的平均治疗效果。
中位随访时间为3.1年。共评估了824张照片。普萘洛尔组的基线美学影响高于局部噻吗洛尔组和观察治疗组（分别为1.85、3.14和3.66；p<0.001）。治疗后，两个治疗组的美学影响相似（7.59、7.93和7.90；p>0.2）。因果模型仅适用于局部噻吗洛尔与观察治疗的比较，未发现任何差异。
这是首个分析婴儿血管瘤美学效果的前瞻性队列研究。三种治疗方法的最终美学结果相似，近40%的患者获得了优秀的美学效果。
