Chinese expert consensus on the use of oral propranolol for treatment of infantile hemangiomas (version 2022)

Infantile hemangioma (IH) is the most common benign vascular neoplasm in children. Although the probability of spontaneous regression is very high, large and rapidly growing hemangioma may result in various sequela after spontaneous involution. Therefore, except for hemangiomas that grow in concealed sites, are small in size, or are in a stable state that can undergo "watchful waiting", aggressive treatment is often required. Since 2008, propranolol has gradually replaced glucocorticoids and become recognized worldwide as first-line treatment for IH. Many studies have reported on its treatment mechanism, both domestically and internationally, resulting in expert consensus and clinical practice guidelines. In recent years, with the continuous accumulation of clinical experience and growing number of studies, there has been a deepening understanding of the pathogenesis of hemangiomas and mechanism of action of propranolol. Thus, it is necessary to update the expert consensus to be more consistent with clinical practice in order to guide medication management and provide scientific norms for the clinical use of propranolol in the treatment of IH. This updated version simplifies the clinical examination, medication, and monitoring process for the use of propranolol in the treatment of IH, making it easier to use.