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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
Rivista di Dermatologia e Malattie Sessualmente Trasmesse
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2016 Ottobre;151(5):485-91
Efficacy of propranolol for cutaneous hemangiomas in premature children
Valeria BRAZZELLI 1, Chiara GIORGINI 1, Stefania BARRUSCOTTI 1, Claudia A. CODAZZI 2, Savina MANNARINO 2, Chryssoula TZIALLA 3, Mauro STRONATI 3, Gian L. MARSEGLIA 2, Giovanni BORRONI 1 ✉
1 Institute of Dermatology, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, San Matteo Polyclinic and Scientific Research Foundation, University of Pavia, Pavia, Italy; 2 Department of Pediatrics, San Matteo Polyclinic and Scientific Research Foundation, Pavia, Italy; 3 Neonatal Intensive Care Unit, San Matteo Polyclinic and Scientific Research Foundation, Pavia, Italy
BACKGROUND: The purpose of the present study is to evaluate the efficacy and safety of propranolol for problematic infantile hemangiomas (IH), showing our experience on 24 children, with special focus on premature infants.
METHODS: A retrospective observational study considered 24 patients who were given oral propranolol for the treatment of “problematic” IH. A multidisciplinary team, composed of a dermatologist, a pediatrician, a pediatric cardiologist, and a neonatologist, took part in the indication for propranolol and follow-up on all the patients. Propranolol was administered orally at the starting dose of 0.5-1 mg/kg/die and was gradually increased to the target dose of 2 mg/kg/die. A clinical gravity score, based on color, major diameter, thickness and texture was calculated for each IH, giving a numeric score before (t0) and after (tf) propranolol therapy. Improvement rate was evaluated in terms of score percentage difference between t0 and tf.
RESULTS: All of the IH except one (96%), showed a variable grade of improvement, with a median score improvement of 69.1%. Median initial score in premature and term infants did not show any significant difference (P=0.38). Otherwise the two subgroups showed a significant difference in final scores: medium percentage improvement in premature and term infants, was respectively 80.9% and 49.6% (P<0.01). No significant side effects were reported during the treatment period.
CONCLUSIONS: As pointed out in our study, IH in premature children showed a significantly better response to propranolol treatment.