Treatment of hemangiomas of infants with high doses of prednisone.

OBJECTIVE

We reviewed our experience with the use of oral corticosteroid therapy in treating hemangiomas of infants to determine the optimal effective dose.

STUDY DESIGN

During a 24-year period, 60 infants with hemangiomas were treated with an initial dose of either 3 or 5 mg/kg per day of orally administered prednisone for a period ranging from 6 to 12 weeks. Involution of the hemangioma and re-growth. were monitored.

RESULTS

Overall, excellent and rapid results were achieved in 68% of infants and good results occurred in 25%. In 7% treatment was deemed to have failed. Forty-seven of 60 patients received one course of therapy, 8 received 2 courses, and 5 required 3 courses. An initial dose of 5 mg/kg per day oral prednisone therapy was more effective than 3 mg/kg per day. Side effects were not serious and resolved after discontinuation of therapy.

CONCLUSIONS

High oral doses of corticosteroids (5 mg/kg per day prednisone) provide an effective, rapid, and safe modality of treatment of hemangiomas of infants. We recommend that treatment continue for 6 to 8 weeks, and in more severe cases for as long as 12 weeks.