Treatment of infantile haemangiomas: recommendations of a European expert group

Eur J Pediatr. 2015 Jul;174(7):855-65. doi: 10.1007/s00431-015-2570-0. Epub 2015 May 29.

Abstract

With a prevalence of 2.6-4.5 %, infantile haemangiomas (IH) represent the most common tumour of infancy. While the majority of IH does not require therapy and regresses spontaneously, about 10 % of IH exhibit complications such as obstruction, ulceration or disfigurement. With the advent of oral propranolol, many conventional treatment options have become obsolete. This paper summarizes current recommendations for management of complicated IH. These recommendations have been written by an expert group after a consensus process including bibliographic review, several drafts of synthesis, meetings with quantitative voting system and redaction of an approved final manuscript.

Conclusion: Oral propranolol is the first-line agent for the treatment of complicated IH.

What is known: • Infantile haemangiomas (IH) are the most common tumours of infancy. Within a very short period after its discovery and long before the publication of randomized controlled trials, propranolol has become the number one agent for the treatment of complicated IH. What is New: • We report IH treatment recommendations of an international, interdisciplinary team of experts, based on an up-to-date review of the literature.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Adrenergic beta-Antagonists / therapeutic use
  • Aortic Coarctation / complications
  • Cryotherapy
  • Diagnosis, Differential
  • Esthetics
  • Eye Abnormalities / complications
  • Glucocorticoids / therapeutic use
  • Hemangioma / diagnosis
  • Hemangioma / therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Laser Therapy
  • Neurocutaneous Syndromes / complications
  • Phototherapy
  • Propranolol / therapeutic use
  • Risk Factors
  • Sirolimus / therapeutic use
  • Vascular Neoplasms / diagnosis
  • Watchful Waiting

Substances

  • Adrenergic beta-Antagonists
  • Glucocorticoids
  • Immunosuppressive Agents
  • Propranolol
  • Sirolimus

Supplementary concepts

  • PHACE association