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First report of topical timolol treatment in primarily ulcerated perineal haemangioma
  1. V Cante,
  2. A Pham-Ledard,
  3. E Imbert,
  4. K Ezzedine,
  5. C Léauté-Labrèze
  1. Unité de dermatologie pédiatrique, CHU Pellegrin, hôpital des enfants, Bordeaux, France
  1. Correspondence to Vincent Cante, CHU Pellegrin, hôpital des enfants, Unité de dermatologie pédiatrique, Place Amelie Léon Raba, 33076 Bordeaux cedex, France; cante_vincent{at}yahoo.fr

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Ulceration, the most common complication of infantile haemangiomas (IH), occurs in about 16% of all IH. Moreover, diaper area, lower lip and neck are the usual risk factor localisations for this occurrence.1 In 2008, Léauté-Labrèze et al2 serendipitously discovered the antiproliferative effect of β blockers on IH. Since then, oral propranolol has become the first-line systemic treatment for complicated IHs, even when ulcerated.3 Following, several publications have reported the use of topical β blockers in non-complicated IH.4 We herein report our personal experience of the use of timolol, a non-selective β blocker, in two neonates with an unusual primarily ulcerated lesion of the perineum area. This study was approved by the institutional review board of our institution.

Case 1 is that of a 24-day-old newborn girl presenting with ulceration on the right buttock. She was born at 39 weeks' estimated gestational age. Birth weight was 3.180 kg. Four days before presentation at our consultation, the parents have noticed a small erosion of the right buttock which has increasingly worsened. The neonate was otherwise healthy …

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