המנגיומה של הילוד – 10 שנות ניסיון של מרכז רפואי אחד.

Background: Infantile hemangioma is the most common tumor in children, with a wide variability of presentation. Most cases resolve spontaneously, and treatment is usually indicated for lesions causing significant morbidity or disfigurement.

Objectives: To assess the efficacy and safety of propranolol as a first-line treatment of infantile hemangioma, with emphasis on the age of therapy initiation.

Materials and Methods: All patients with infantile hemangioma referred to our clinic between 2009-2019 were enrolled. During each checkup, the hemangiomas were photo-documented and compared to previous photos made on the initial and consequent clinical evaluations. The clinical results were assessed and reviewed according to the change of shape, size, texture, depth, and recurrence. Side effects and other clinically or routinely collected data of the hemangioma lesions were also reviewed.

Results: A total of 263 patients with infantile hemangioma were referred to our dermatological outpatient clinic from 2009 to 2019, of whom 205 patients enrolled. The mean age at the initiation of propranolol was 4.7 months (Ranges 1-19 months, SD, 3.85). 129 (63%) patients had improvement of more than 90%; 43 (21%) had improvement of 71%-89% and 25 (12%) patients had improvement of 50%-70%. 8 (4%) patients had less than 50% improvement. Infants with facial hemangioma had a better response to propranolol treatment. All patients experienced some degree of clinical resolution, with the average improvement rate being estimated at 77.1% (SD, 16.1). Twenty-eight patients were above the age of 9 months at the initiation of therapy. Comparable results were achieved among patients who were placed on propranolol at an age older than 12 months and those managed between the age of 9 and 12 months. No serious adverse events were observed during the follow-up duration.

Conclusion: Propranolol is a highly effective and safe therapy for infantile hemangioma. Effectiveness may be maintained even when therapy is initiated after 12 months of age.