Current treatment and management of infantile hemangiomas

Satterfield, Kellie R.; Chambers, Christopher B.

doi:10.1016/j.survophthal.2019.02.005

Cited by 68 publications

(93 citation statements)

References 137 publications

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“…Most IHs (70% to 80%) can be left untreated and allowed to follow their natural course without negative consequences[17,18]. Unfortunately, in the other cases, it is now possible to find residual changes such as fibrofatty tissue, scarring, or simply telan-giectasia, wrinkling, and dyspigmentation, which significantly affect the patients and their families both physically and psychologically[16].…”

Section: Discussionmentioning

confidence: 99%

Noteworthy effects of a long-pulse Alexandrite laser for treatment of high-risk infantile hemangioma: A case report and literature review

Xue

2019

WJCC

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BACKGROUND We have previously proved that treatment of thick/deep infantile hemangiomas (IHs) with a long-pulse Alexandrite laser was clinically effective and safe. This article aims to investigate the efficiency of long-pulse Alexandrite laser use in treating thick and high-risk IHs located in particular anatomic areas and provides some new data on this issue. CASE SUMMARY A two-month-old girl with a thick and high-risk IH covering most of the right labia majora was examined in this study. The infant received four treatment sessions at 4- to 6-wk intervals with a long-pulse Alexandrite laser with settings as follows: 3 ms pulse duration, 8 mm spot size, 45 to 50 J/cm 2 fluences, and dynamic cooling device (DCD) spray duration of 90 ms with a delay of 80 ms. Following each of the four treatment sessions, the IH showed a remarkable reduction in thickness and size without any sign of relapse. Ten months after the last treatment, the IH had completely regressed without adverse effects. During the laser treatment, no severe side effects were observed; blistering occurred only immediately after treatment and then scabbed over the next day, gradually improving in the following days. CONCLUSION Long-pulse Alexandrite laser treatment may be considered one of the first-line noninvasive therapeutic options for the treatment of thick IH.

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Section: Discussionmentioning

confidence: 99%

Noteworthy effects of a long-pulse Alexandrite laser for treatment of high-risk infantile hemangioma: A case report and literature review

Xue

2019

WJCC

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“…Infantile hemangioma (IH) is known as one of the most common tumors of childhood, with an incidence of 5–10% in infants [ 1 , 2 ]. Risk factors of IHs include prematurity, low birth weight infants, white race and females [3] .…”

Section: Introductionmentioning

confidence: 99%

“…Risk factors of IHs include prematurity, low birth weight infants, white race and females [3] . IHs often involve the head and neck, and can result in local tissue damage, ulceration, infection, bleeding, functional impact, and disfigurement [ 2 – 4 ]. Early treatment of IHs may potentially mitigate complications.…”

Section: Introductionmentioning

confidence: 99%

“…Early treatment of IHs may potentially mitigate complications. However, there are so many therapeutic protocols (systemic or topical β-blockers, corticosteroids, imiquimod, laser therapy and so on) for clinical doctors [ 2 , 4 , 5 ], it is virtually impossible to cover all the combinations in direct head-to-head RCTs in order to determine the optimal option. The application of network meta-analysis (NMA), which is able to synthesize the results of direct and indirect comparisons simultaneously to obtain a more accurate and precise statistical result, makes it possible to overcome the limitation [6] .…”

Section: Introductionmentioning

confidence: 99%

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Treatments for infantile Hemangioma: A systematic review and network meta-analysis

2020

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Background Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis. Methods We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability. Findings A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction. Interpretation A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred. Funding No funding was received.

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“…Generally speaking, the involute Hem generates little residua and requires no special treatment [6]. Still, the inappropriate volume or location of Hem might be a visual or even life-threating lesion as the tumor, especial on the face, could inflict cosmetic or lifelong sequelae [4]. These entire dilemmas require novel targets and treatment to reduce the pathogenesis and evolution of Hem.…”

Section: Introductionmentioning

confidence: 99%

Silencing microRNA-210 in Hypoxia-Induced HUVEC-Derived Extracellular Vesicles Inhibits Hemangioma

Tao

Huang

2020

Cerebrovasc Dis

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Background: Hemangioma (Hem) is a benign tumor commonly seen in infancy with a relative high morbidity. Human umbilical vein endothelial cell (HUVEC)-derived extracellular vesicles (EVs) are actively participated in Hem. Therefore, this study is designed to figure out the underlying mechanism of HUVEC-derived EVs in Hem. Methods: Initially, EVs were separated from HUVECs and identified. HUVEC-derived EVs in normoxia or hypoxia were then cultivated with Hem endothelial cells (HemECs) to test the proliferation, apoptosis, and migration of HemECs. Microarray analysis was performed to select microRNAs (miRs) with differential expression. miR-210 in hypoxia-induced HUVECs was silenced, and the relevant EVs were extracted and then co-cultured with HemECs to perform biological effect experiments. Then, the target relation between miR-210 and homeobox A9 (HOXA9) was identified by the dual luciferase reporter gene assay and RNA immunoprecipitation assay. Moreover, xenograft transplantation was also applied to confirm the in vitro experiments. Results: Hypoxia-induced HUVECs promoted release of EVs, which were absorbed by HemECs. Hypoxia-induced HUVEC-EVs promoted HemEC proliferation and migration and inhibited apoptosis. miR-210 from the hypoxia-induced HUVEC-EVs was highly expressed and promoted HemEC growth. Silencing miR-210 expression in the hypoxia-induced HUVEC-EVs suppresses Hem development in vivo. In addition, miR-210 targeted HOXA9. Conclusion: Silencing miR-210 in HUVEC-derived EVs could suppress Hem by targeting HOXA9. This investigation may provide novel insights for Hem treatment.

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Current treatment and management of infantile hemangiomas

Cited by 68 publications

References 137 publications

Noteworthy effects of a long-pulse Alexandrite laser for treatment of high-risk infantile hemangioma: A case report and literature review

Noteworthy effects of a long-pulse Alexandrite laser for treatment of high-risk infantile hemangioma: A case report and literature review

Treatments for infantile Hemangioma: A systematic review and network meta-analysis

Silencing microRNA-210 in Hypoxia-Induced HUVEC-Derived Extracellular Vesicles Inhibits Hemangioma

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