Hemangioma medical therapy: Difference between revisions

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:*[[Interferon]]
:*[[Interferon]]
:*[[Vincristine]]
:*[[Vincristine]]
::*These agents have also been used for:
::*These agents have also been used for:<ref name="RichterFriedman2012">{{cite journal|last1=Richter|first1=Gresham T.|last2=Friedman|first2=Adva B.|title=Hemangiomas and Vascular Malformations: Current Theory and Management|journal=International Journal of Pediatrics|volume=2012|year=2012|pages=1–10|issn=1687-9740|doi=10.1155/2012/645678}}</ref>
 
:::*Multifocal disease
:::*Multifocal disease
:::*Visceral involvement
:::*Visceral involvement
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*The indication spectrum includes vascular tumors including hemangiomas.
*The indication spectrum includes vascular tumors including hemangiomas.
===Propranolol===
===Propranolol===
*A paradigm shift has occurred regarding the treatment of hemangiomas over the past few years.
*A paradigm shift has occurred regarding the treatment of hemangiomas over the past few years.<ref name="RichterFriedman2012">{{cite journal|last1=Richter|first1=Gresham T.|last2=Friedman|first2=Adva B.|title=Hemangiomas and Vascular Malformations: Current Theory and Management|journal=International Journal of Pediatrics|volume=2012|year=2012|pages=1–10|issn=1687-9740|doi=10.1155/2012/645678}}</ref>
 
*Propranolol, a nonselective β-adrenergic antagonist, was serendipitously discovered to cause regression of proliferating hemangiomas in newborns receiving treatment for cardiovascular disease.
*Propranolol, a nonselective β-adrenergic antagonist, was serendipitously discovered to cause regression of proliferating hemangiomas in newborns receiving treatment for cardiovascular disease.
*Numerous studies demonstrating the success of propranolol for shrinking hemangiomas
*Numerous studies demonstrating the success of propranolol for shrinking hemangiomas

Revision as of 20:31, 17 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

Medical Therapy

  • Medical and surgical options are available for the treatment of “problematic” hemangiomas.[1]
  • Medical management includes one or more systemic therapies.
  • For massive and life-threatening disease:[1]
  • These agents have also been used for:[1]
  • Multifocal disease
  • Visceral involvement
  • Segmental distribution
  • Airway obstruction
  • Periorbital lesions

Intense pulsed light

  • IPL flash lamps emit broadband polychromatic high-intensity light in the wavelength spectrum ranging 515-1200nm.[2]
  • They target vessels at various depths inside the skin.
  • The effect relies on selective photothermolysis.
  • The indication spectrum includes vascular tumors including hemangiomas.

Propranolol

  • A paradigm shift has occurred regarding the treatment of hemangiomas over the past few years.[1]
  • Propranolol, a nonselective β-adrenergic antagonist, was serendipitously discovered to cause regression of proliferating hemangiomas in newborns receiving treatment for cardiovascular disease.
  • Numerous studies demonstrating the success of propranolol for shrinking hemangiomas
  • Over ninety percent of patients have dramatic reduction in the size of their hemangiomas as early as 1-2 weeks following the first dose of propranolol.
  • Dosing for propranolol in treating hemangiomas is recommended to be 2-3 mg/kg separated into two or three-times-a-day regimens.
  • These doses are dramatically below the concentration employed for cardiovascular conditions in children.

References

  1. 1.0 1.1 1.2 1.3 Richter, Gresham T.; Friedman, Adva B. (2012). "Hemangiomas and Vascular Malformations: Current Theory and Management". International Journal of Pediatrics. 2012: 1–10. doi:10.1155/2012/645678. ISSN 1687-9740.
  2. Caucanas, Marie; Paquet, Philippe; Henry, Frédérique; Piérard-Franchimont, Claudine; Reginster, Marie-Annick; Piérard, Gérald E. (2011). "Intense Pulsed-Light Therapy for Proliferative Haemangiomas of Infancy". Case Reports in Dermatological Medicine. 2011: 1–5. doi:10.1155/2011/253607. ISSN 2090-6463.

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