Enhanced Percutaneous Delivery of Beta-Blockers Using Thermal Resurfacing Drug Delivery System for Topical Treatment of Infantile Hemangiomas

Mashiah, Jacob; Bar‐Ilan, Efrat; Koren, Amir; Friedman, Or; Zur, Eyal; Artzi, Ofir

doi:10.1159/000507808

Cited by 3 publications

(3 citation statements)

References 20 publications

(38 reference statements)

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“…Thermomechanical injury has already been used to deliver botulinum toxin to mediate rosacea and Hailey-Hailey disease, 26,27 triamcinolone and 5-fluorouracil to reduce scar size, 28,29 rapamycin for enhanced pulsed dye laser treatment of port-wine stains, 30 and beta blockers for infantile hemangiomas. 31 Depending on the selected treatment parameters, the fractional thermomechanical device can allow for ablative or nonablative histologic effects because of heat transfer from short contact of the 400°C-heated pyramidal tip, 11 which can attain similar ablative temperatures to the CO2 laser. 32 Both low-energy, low-density, fractional nonablative lasers initially produced channels.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery

et al. 2021

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BACKGROUND Topical medications play a large role in the management of cutaneous diseases, but penetration is limited. Device-assisted drug delivery using mechanical destruction, lasers, and other energy-based modalities can increase penetration and absorption through creation of transcutaneous channels. OBJECTIVE To examine real-time, in vivo cutaneous changes in response to various devices used to improve topical drug delivery through optical coherence tomography (OCT) imaging. METHODS AND MATERIALS Treatment was performed with 8 medical devices, including mechanical destruction, lasers, and other energy-based modalities. Optical coherence tomography was used for real-time, noninvasive, in vivo imaging. RESULTS Using OCT, microneedling and radiofrequency microneedling demonstrated no cutaneous channels. Both lowenergy, low-density, fractional nonablative lasers produced transient channels, which closed within hours. The fractional nonablative 1,927-nm thulium fiber and 1,550-nm erbium fiber lasers created channels with epidermal debris within, which were still closing at 24 hours. The fractional thermomechanical ablative device and the fractional ablative CO2 laser produced channels that were still open at 24 hours. CO2 laser channels had thick rims of coagulated tissue and remained open for longer. CONCLUSION Demonstrable differences among the devices were seen, and only some can produce observable channels, the characteristics of which vary with each technology.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery

et al. 2021

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“…7 Some studies reported that some methods enhanced the bioavailability of topical treatment, such as lasers, microneedles and topical drug delivery systems, but most of these methods lead to pain or have complex equipment requirements. [11][12][13] Intralesional corticosteroid injection is safe, easy and effective in arresting hemangioma proliferation and is recommended for the treatment of localized deep hemangiomas. 14 However, superficial injection of diprospan may lead to ulceration, and a large volume of injected diprospan may result in complications.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that topical beta-blockers work in only superficial tumors with a thickness less than 2 mm 7 . Some studies reported that some methods enhanced the bioavailability of topical treatment, such as lasers, microneedles and topical drug delivery systems, but most of these methods lead to pain or have complex equipment requirements 11–13 …”

Section: Discussionmentioning

confidence: 99%

Topical Timolol Combined Intralesional Injection of Diprospan in the Treatment of Elevated Localized Mixed Infantile Hemangiomas and a Discussion for Proper Timing for Injection

Zhang¹,

Lan

Li³

et al. 2021

Journal of Craniofacial Surgery

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Background: Although infantile hemangiomas (IHs) are usually self-limiting, residual elevated appearance may remain. Topical betablockers are effective in superficial IHs management, while intralesionally injected diprospan is effective at treating deep, localized IHs. A single application of topical timolol or injected diprospan has obvious limitations. Therefore, for elevated, localized mixed IHs, we applied topical timolol combined with intralesionally injected diprospan, using their respective advantages to maximize benefits. Purpose: To evaluate the clinical efficacy and safety of topical timolol combined with intralesionally injected diprospan for the treatment of elevated, localized mixed IHs and identify the optimal injection time. Methods: Infants with elevated, localized mixed IHs in the proliferative phase were treated with injected diprospan combined with topical timolol between March 2018 and March 2020. The injection was administered only when the tumor surface was higher than that of the surrounding tissue. The patients were asked to return every 4 weeks for a treatment response evaluation, and complications were recorded. Results: Thirty-six patients with elevated, localized mixed IHs (thickness >3 mm on Doppler ultrasound) were recruited. The mean age at treatment initiation was 3.58 AE 1.50 months (range: 1.00-6.00 months). The follow-up period ranged from 9 to 24 months.Considering the size of the IH at the end of treatment, regression was observed in 31 (86.1%) cases, stabilization was observed in 5 (13.9%) cases, and no treatment failure was observed. All the IHs improved in color and height after treatment. Conclusion: Topical timolol combined with intralesionally injected diprospan is an effective and safe treatment for elevated, localized mixed IH. The injection is needed only when we forecast the elevated tissue may remain after regression.

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Clinical and morphological characteristics and diagnosis of external haemangiomas in children

Toktosunova,

Toktosunov,

Sharshenov

2023

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Background. The relevance lies in the increasing occurrence of haemangiomas in children under 1 year old when diagnosis confirmation through morphological methods is necessary. The purpose of the research is to characterise the histological initial and final changes of cutaneous haemangiomas and to present the main clinical manifestations of haemangiomas in children. Materials and methods. Several clinical (for detailed diagnosis of the disease), morphological (histological examination of the material) and statistical methods were used in the work. The object of the research was 98 children with haemangiomas of the facial skin aged 6 months to 16 years. Results. The morphological study demonstrated that in 49 cases (50 %), the typical simple capillary structure of haemangioma was identified, in 35 cases (35.7 %) — cavernous type of neoplasm. Only 18.3 % of the children had combined haemangiomas. Capillary-type haemangiomas contain many small capillaries with a narrow lumen, covered by adhering fleshy epithelium. Conclusions. During the phase of the active growth of haemangiomas, there is a predominance of massive endothelial cells, suggesting that the vascular component, particularly proliferating epithelium-lined capillaries, makes up the main and largest part of the hyperplasia.

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Enhanced Percutaneous Delivery of Beta-Blockers Using Thermal Resurfacing Drug Delivery System for Topical Treatment of Infantile Hemangiomas

Cited by 3 publications

References 20 publications

Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery

Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery

Topical Timolol Combined Intralesional Injection of Diprospan in the Treatment of Elevated Localized Mixed Infantile Hemangiomas and a Discussion for Proper Timing for Injection

Clinical and morphological characteristics and diagnosis of external haemangiomas in children

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