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Speciality Spotlight
Hemangioma
- Vascular Malformations
Boon LM, MacDonald DM, Mulliken JB (Harvard Med School, Boston)
Complications of Systemic Corticosteroid Therapy for Problematic Hemangioma
Plast Reconstr Surg 104:1616-1623, 1999
The short- and long-term effects of systemic carticosteroid therapy for problematic hemangioma in children were reviewed.
The short-term side effects of systemic carticosteroid therapy to treat problematic hemangiomas in infants were minor and generally resolved as therapy was discontinued. The only long-term side effects noted were 2 cases of shorter-than-predicted height at 6 years of age.
Thus, an initial corticosteroid dose of 2 to 3 mg/kg per day that is gradually tapered and discontinued before 1 year of age is safe and effective in treating endangering hemangiomas in infants.
- Burstein FD, Simms C, Cohen SR, et al (Scottish Rite Children’s Med Ctr, Altana, Ga; San Diego Ctr for Plastic, Oral & Maxillofacial Surgery, Calif; Atlanta Plastic Surgery, Ga)
Intralesional Laser Therapy of Extensive Hemangiomas in 100 Consecutive Pediatric Patients
Ann Plast Surg 44:188-194, 2000
Most surgeons agree that hemangiomas that interfere with vision, that infringe on body orifices, that are ulcerated or secondarily infected, that have substantial bleeding, or that undergo rapid and uncontrollable growth should be treated.
Treatments were continued until the lesion’s vascularity had decreased enough that it could be safely removed without causing major disfigurement or, for unresectable lesions, when the lesion has involuted and fibrosed until the functional and aesthetic impact was minimized.
Intralesional laser therapy is safe and effective in the treatment of functionally significant capillary/cavernous hemangioma in children. It allows for the safe removal of inoperable intrusive lesions, and it reduces the size and impact of unresectable lesions. The Nd:YAG and KTP lasers were equally effective in treating these childhood lesions.
The authors show some gratifying results and a low complication rate of 4%.
