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Incidence and treatment of infantile haemangioma in preterm infants
  1. Rangmar Goelz,
  2. Christian F Poets
  1. Department of Neonatology, University Children's Hospital Tuebingen, Tuebingen, Germany
  1. Correspondence to Dr Rangmar Goelz, University Children's Hospital Tuebingen, Department of Neonatology, Calwerstrasse 7, Tuebingen D-72076, Germany; Rangmar.Goelz{at}med.uni-tuebingen.de

Abstract

Infantile haemangioma (IH) are vascular tumours with a unique growth dynamic, mostly absent at birth, growth in the first months followed by involution over several years, often resulting in residual skin changes. Immune-histologically, IH cells are exclusively glucose transporter protein-1 positive.The incidence of IH is increasing with decreasing gestational age, from 1–4% in term infants to 23% in those of <1000 g birth weight, with a female and Caucasian predominance. Discovery of systemic and topical beta blockers as an effective treatment option resulted in a rapid shift away from systemic steroids towards these drugs. For preterm infants, however, data on efficacy, pharmacokinetics and long-term safety are sparse or absent. Topical treatment without systemic side effects like cryotherapy may thus be an attractive alternative at an early growth stage (<10 mm). Indications for treatment with beta blockers, mostly propranolol systemically and timolol maleat 0.5% topically, are currently extrapolated from studies in older infants. Both seem effective, but adverse effects on sleep, circulation and metabolism are well described for propranolol. Long-term outcome data for either drug are missing. In conclusion, evidence on optimal IH treatment in preterms is lacking despite their high incidence; pharmacokinetic and clinical studies are warranted.

  • Infantile Haemangioma
  • preterm
  • incidence
  • treatment
  • Neonatology

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