Analysis of the modern treatment protocols for complicated and uncomplicated infantile hemangiomas. Literature review and own data

Abstract

Infantile hemangioma (IH), a benign tumor of the vascular endothelium, is the most common type of vascular pathology of the infant’s skin, which grows and significantly increases in size mostly during the first 12 months of a child's life. Statistics indicate that IH affects up to 10% of newborns and children aged <1 year. The proliferative activity of IHs during the first year of a child's life differs significantly and could mislead parents and doctors. Lack of timely treatment at an early stage leads to an increase in the size of the tumor and high risks of cosmetic defects. Thus, the proliferation of IH can cause a gross deformation of the skin and a dysfunction of nearby organs. Purpose - to analyze modern data on the treatment of patients with complicated and uncomplicated hemangiomas, to study international experience and compare it with own observations and own experience, and to improve patient treatment protocols. In this review, we analyzed 19 articles involving more than 2400 children with different types of IH, compared different treatment protocols, their outcomes, and complications, and demonstrated our methods, results, and clinical cases. It may be resumed that β-blockers are “first-line” drugs for local and systemic treatment of IHs, as they allow slowing of the proliferation and activating resorption of the tumor without cosmetic defects or complications. Treatment of IH in babies following modern treatment protocols should be carried out non-surgically, without operations, anesthesia, scars, or cosmetic defects. Ulceration is the most common complication of IHs and the result of the late start of the treatment and thus could be prevented by the timely beginning of the therapy. No conflict of interests was declared by the authors.

Keywords

• infantile hemangioma
• ulceration
• treatment
• β-blocker
• surgery
• telemedicine
• vascular lasers