Should all infantile hemangiomas be treated? − Time to learn, unlearn, and relearn

Abstract

Introduction: The quality of life of both the child and their caretakers has been noted to be adversely affected by visible birthmarks and resultant scarring, particularly in areas that cannot be easily covered. With the current knowledge about the uncertain trend in the progression of infantile hemangiomas (IH), the risks associated with it, and the availability of safe and effective treatment options available, a question arises, that should all hemangiomas be treated? A national survey was conducted to determine dermatologists' opinions throughout the country followed by the analysis and literature review. Methodology: An anonymous questionnaire of 10 questions was shared among dermatologists of the country using a link distributed through the electronic media. The data submitted anonymously by the responders were analyzed after due permission for its use for research and publication was received. Results: A total of 91 clinicians completed the questionnaires. 54.95% of the respondents answered that they would wait and watch in the majority of the cases presenting to them. 83.52% of the responders chose topical timolol as the most common medical treatment modality. 33.71% of the responders reported the resolution of IH in more than 75% of their patients and fibrofatty residue was the most common sequelae reported post the involuntary stage. 65.56% of the responders answered no to the question − “Should all hemangiomas be treated?” Conclusion: Clinical experience backed with research has proved the efficacy of beta-blockers in the resolution of IH beyond doubt. The need to identify, evaluate, and initiate timely treatment is required to avoid missing the window of opportunity to optimize the outcomes.

Keywords

• infantile hemangioma
• pediatric dermatology
• propranolol
• timolol
• treatment