Early intervention and/or referral recommended for potentially problematic infantile hemangiomas
WEDNESDAY, Dec. 26, 2018 (HealthDay News) — The American Academy of Pediatrics has developed its first guideline for the management of infantile hemangiomas (IHs); the clinical practice guideline was published online Dec. 24 in Pediatrics.
Noting that IHs may occur in as many as 5 percent of infants, and that a considerable minority are potentially problematic, Daniel P. Krowchuk, M.D., from the Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues developed clinical guidelines for the management of IHs.
The authors defined potentially higher risk IHs, which should prompt concern, and highlighted the importance of increased vigilance, consideration of active treatment, and specialty consultation when appropriate. The most rapid and significant growth occurs between age 1 and 3 months; in most cases, growth is completed by 5 months of age. For infants who have potentially problematic IHs, early intervention and/or referral is recommended; ideally by 1 month of age. Propranolol is the drug of choice when systemic treatment is indicated, at a dose of 2 to 3 mg/kg/day. Treatment is usually continued for at least six months, and is maintained until 12 months and sometimes for longer. Select, small, thin, superficial IHs may be treated with topical timolol. For treatment of residual skin changes after involution, surgery and/or laser treatment are most useful.
“The subcommittee hopes this clinical practice guideline will be viewed as an effective guide to IH triage and management and to minimize poor outcomes from higher-risk IHs,” the authors write.
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