Treatment of rapidly proliferating haemangiomas in newborns with propranolol and review of the literature

Aim: Infantile haemangiomas (IH) are neoplastic proliferations of endothelial cells which occur with an incidence of 10-12%. IH rapidly growing and found in cosmetically sensitive areas or complicated with ulcerations are of special concern of parents.Methods: A review of medical charts was performed for newborns treated with propranolol because of IH between 2012 and 2013. There were two boys and two girls, referred to our department at the age of 2-3 weeks. Children were commenced on propranolol 0.5mg/kg daily and closely monitored. The dosage was increased up to a maximum of 2mg/kg/d and was maintained until the lesion had involuted or showed good result.Results: The minimal dosage required to achieve involution was 1.5-2.0mg/kg/d. No rebound growth or complications were observed. Three patients showed excellent response with resolution of the lesion. Fourth patient showed good result with >50% reduction of IH.Conclusions: Propranolol at 1.5-2.0mg/kg/d is effective and safe for treating IH in our series of newborn patients. Treatment should be maintained until the lesion is involuted or shows good cosmetic result. Still there is need for larger scale studies confirming the safety and efficacy of propranolol in treatment of haemangiomas in newborns.