Therapy of Ulcerated Hemangiomas. Issue 4 (July 2013)

• Record Type: Journal Article
• Authors: McCuaig, Catherine C.; Cohen, Lynn; Powell, Julie; Hatami, Afshin; Marcoux, Danielle; Maari, Catherine; Caouette-Laberge, Louise; Bortoluzzi, Patricia; Ondrejchak, Sandra; Dubois, Josée
• Is Part Of: Journal of cutaneous medicine and surgery. Volume 17:Issue 4(2013)
• Page Start: 233
• Page End: 242
• Publication Date: 2013-07
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Treatment -- Periodicals; Skin -- Surgery -- Periodicals; Dermatology -- Canada -- Periodicals; Skin -- Diseases -- Treatment -- Canada -- Periodicals; Skin -- Surgery -- Canada -- Periodicals; 616.5005
• DOI: 10.2310/7750.2012.12037
• Languages: English
• ISSNs: 1203-4754

Abstract

Background: Cutaneous ulceration is the most common complication of infantile hemangiomas (IHs) seen in a pediatric dermatology practice. Objective: The most effective treatments in our experience are compared to those in the current literature. Methods: The study was a retrospective chart review of therapy of 169 ulcerated IHs at a tertiary care pediatric hospital and a literature review. Results: Combination therapy was the rule. Local wound care was required in all, pain management in 72%, pulsed dye laser in 42%, infection control in 38%, diminution of the hemangioma through systemic therapy in 36%, and suppression of bleeding in 2%. Limitations: A retrospective review compared to a case-control study has inherent bias. In addition, our cases were all at a tertiary referral center. Conclusion: All ulcerated IHs benefit from local barrier creams or dressings. Pulsed dye laser, antibiotics, topical morphine 0.1% in hydrogel, topical becaplermin, and, most importantly, systemic therapy (especially propranolol) to reduce the hemangioma may be useful.