| Abstract: |
Infantile haemangiomas (IH) are the most common tumors of infancy with an incidence of >2% of infants in general, and of 10% of Caucasian children, in particular. IH typically presents few a weeks after births, and occur more frequently in girls. Although benign, severe IH can also be life threatening if it affects the airways. Despite their tendency to undergo spontaneous regression, their management can be challenging. Various modalities have been applied for treating of IHs: watchful waiting, administration of a high dose of corticosteroids, vincristine or interferon alpha, or use a ‘‘cold knife’’, laser surgery and cryosurgery. Each of these options involves significant drawbacks and/or side effects Recently Leaute, Labreze et al. described their serendipitous observation of an antiproliferative effect of propranolol on IH. Since the original publication of their finding in 2008, several papers emphasized the effectiveness of propranolol on IH. During the last four-year-period, propranolol became the first-line treatment of children with IH. The correct mechanism of the drug is not quite clear, a possible molecular effect of propranolol to different target points in IHs has been documented. Minimal or no side effects have been reported, and the regression rate has been near to 100% The primary adverse effects reported with propranolol use in infants have been somnolence, hypotension, bradycardia, bronchospasm, and hypoglycemia In this study, we review the literature of the efficacy and safety of propranolol in treating infants and children with severe infantile hemangioma We also clarify the pathogenesis, phases and diagnostic features of infantile hemangioma that may help us understand the possible mechanism of action of propranolol on IH.
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