Factors associated with delayed referral for infantile hemangioma necessitating propranolol

Onnis, G L; Dreyfus, I.; Mazereeuw‐Hautier, J.

doi:10.1111/jdv.14842

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…Our data showed a notable incidence of vermilion IHs. The sex ratio of female to male cases of lip IHs was 1.4 : 1, and this result is in line with previously published data 7,8,9 . Although it is reported that low birth weight appears to be the most significant risk factor for IHs, with a 40% increase in risk for every 500‐g decrease in birth weight, 10,11 none of the patients in the current study weighed less than 2.0 kg.…”

Section: Discussionsupporting

confidence: 92%

Clinical characteristics of lip infantile haemangiomas and main risk factors for ulceration: an 8‐year retrospective study of 69 Chinese infants

Yan

et al. 2020

Acad Dermatol Venereol

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Background Infantile haemangiomas (IHs) involving the lip are of special concern because of the susceptibility of complications, including ulceration, obstruction and disfigurement. The available data for the relationship between their clinical characteristics and ulcerations are limited. Objectives To describe the clinical characteristics of lip IHs and to evaluate the main risk factors for ulceration. Methods A retrospective study was designed that included infants with lip IHs during an 8‐year period, the clinical data of participants were collected, and univariable and multivariable logistic models were used to determine the relationships between the clinical characteristics of lip IHs and ulcerations. Location, size and type were investigated as potential independent factors influencing the development of ulceration. Results A total of 69 lip IHs were identified including 40 girls and 29 boys. Ulcerations were found in 37 (53.6%) lip IHs. Lip haemangiomas experiencing ulceration had a mean size (SD) of 3.49 (2.82) cm2 compared with 1.08 (0.96) cm2 for those without ulceration. Twenty‐eight (52.8%) of the 53 localized haemangiomas and 9 (56.3%) of the 16 segmental haemangiomas experienced ulcerations. Univariable analyses of all investigated factors revealed significant associations of location and size with increased risk of ulceration, and these significant associations remained after adjusting for sex and age [OR 8.61 (95% CI, 2.24–33.13) and 2.62 (95% CI, 1.46–4.72), respectively]. The duration before ulceration was between 4 and 70 days after the occurrence of lip IHs, with a median of 28 (19.41) days. Most ulcers occurred within 45 days of IH occurrence. Conclusions Ulceration is a common complication of lip IHs at an earlier stage. A swollen with pale or bright crimson appearance of the lip IH surface could be an important signal of subsequent ulceration. Location of the IH on the lower lip and lip IH size are risk factors for the occurrence of ulceration.

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Section: Discussionsupporting

confidence: 92%

Clinical characteristics of lip infantile haemangiomas and main risk factors for ulceration: an 8‐year retrospective study of 69 Chinese infants

Yan

et al. 2020

Acad Dermatol Venereol

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“…Usually, late treatment initiations are related to a delayed referral to the specialist, especially for superficial IH. 29 The safety analysis found AEs in 26.6% patients, which is consistent with previous studies on oral propranolol, which reported AEs rates from 19.6% 30 to 38.2%. 31 Sleep disturbances, wheezing and digestive side effects were the most frequently reported AEs in our cohort, as described in the previous studies, however peripheral coldness was not reported in our cohort.…”

Section: Adverse Eventssupporting

confidence: 90%

“…Late Hemangiol initiations >5 months of age concerned 29 subjects in our study. Usually, late treatment initiations are related to a delayed referral to the specialist, especially for superficial IH 29 …”

Section: Discussionmentioning

confidence: 99%

Hemangiol in infantile haemangioma: A paediatric post‐marketing surveillance drug study

Socchi

Bigorre

Normandin

et al. 2020

Brit J Clinical Pharma

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HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…2,6 Indeed, the timing of therapy is critical in severe IH because early treatment during the proliferative phase will result in higher response rates, and therefore improve outcomes. 7,8 Many authors have already emphasized the importance of early referral of high-risk IH to multidisciplinary vascular anomaly centers with experienced subspecialists, especially because the discovery of the effectiveness of propranolol for IHs has led to changing treatment decisions in IHs, with more frequent and earlier treatment. 1,9 Unfortunately, clinical studies have revealed that despite the fact that most IH growth is completed at ∼5 months of age, infants are often referred at a later age.…”

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confidence: 99%

The Infantile Hemangioma Referral Score: A Validated Tool for Physicians

et al. 2020

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and Troilius Rubin created the Infantile Hemangioma Referral Score tool, selected the 42 clinical cases for validating the tool (stage 1), and validated the study design; Drs van der Vleuten and Roessler participated in the validation of the gold standard (stage 2); and all authors discussed and validated the study results (including the choice of the threshold), reviewed and validated the manuscript, approved the final manuscript as submitted, and agree to be accountable for all aspects of the work.

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Factors associated with delayed referral for infantile hemangioma necessitating propranolol

Abstract: This study adds to our understanding regarding delayed referral and has identified targets for future information campaigns.

Cited by 10 publications

References 21 publications

Clinical characteristics of lip infantile haemangiomas and main risk factors for ulceration: an 8‐year retrospective study of 69 Chinese infants

Clinical characteristics of lip infantile haemangiomas and main risk factors for ulceration: an 8‐year retrospective study of 69 Chinese infants

Hemangiol in infantile haemangioma: A paediatric post‐marketing surveillance drug study

The Infantile Hemangioma Referral Score: A Validated Tool for Physicians

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