PMID- 22958179
OWN - NLM
STAT- MEDLINE
DCOM- 20130807
LR  - 20131121
IS  - 1525-1470 (Electronic)
IS  - 0736-8046 (Linking)
VI  - 30
IP  - 1
DP  - 2013 Jan-Feb
TI  - Infantile hemangioma: treatment with short course systemic corticosteroid therapy 
      as an alternative for propranolol.
PG  - 64-70
LID - 10.1111/j.1525-1470.2012.01846.x [doi]
AB  - Infantile hemangiomas (IHs) are increasingly being treated with propranolol or 
      other beta-blockers, but before this therapeutic option was available, oral 
      glucocorticosteroids (GCSs) were the criterion standard treatment and are still 
      the alternative modality in problematic cases. Nevertheless, there is no standard 
      treatment protocol for the dose and duration of GCSs. Long-term treatment with 
      GCSs is associated with unwanted side effects such as growth suppression, 
      behavioral changes, and reflux. Twenty-one children with troublesome IHs were 
      treated according to an algorithm with 3 mg/kg/day of oral prednisolone divided 
      three times per day with varying duration and number of GCS courses. Two blinded 
      investigators independently interpreted therapy results using the Hemangioma 
      Activity Score (HAS). Side effects were determined according to reports in 
      patient charts and parental questionnaires. The median duration of a short course 
      of GCSs was 2 weeks (range 1-6 weeks). The number of courses was 2 (range 1-5). 
      The median cumulative dose was 91 mg/kg. Growth stabilized in all patients, with 
      a good response (>50% reduction in HAS) in 62% and a favorable response (30-50% 
      reduction is HAS) in 23%. Twelve of the 21 children (57%) had minor side effects. 
      Persistent side effects did not occur. Intermittent short course, systemic, 
      high-dose GCS therapy is an effective and safe treatment modality for IH, with a 
      substantially lower cumulative dose of GCSs compared to prolonged therapy and no 
      major side effects. This treatment is an alternative in cases in which 
      propranolol fails or is contraindicated.
CI  - (c) 2012 Wiley Periodicals, Inc.
FAU - Nieuwenhuis, Klaske
AU  - Nieuwenhuis K
AD  - Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University 
      Medical Center, Rotterdam, The Netherlands.
FAU - de Laat, Peter C J
AU  - de Laat PC
FAU - Janmohamed, Sherief R
AU  - Janmohamed SR
FAU - Madern, Gerard C
AU  - Madern GC
FAU - Oranje, Arnold P
AU  - Oranje AP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120907
PL  - United States
TA  - Pediatr Dermatol
JT  - Pediatric dermatology
JID - 8406799
RN  - 0 (Glucocorticoids)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - 9Y8NXQ24VQ (Propranolol)
RN  - Hemangioma, capillary infantile
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/adverse effects/therapeutic use
MH  - Hemangioma, Capillary/congenital/*drug therapy/pathology
MH  - Humans
MH  - Male
MH  - Neoplastic Syndromes, Hereditary/congenital/*drug therapy/pathology
MH  - Prednisolone/*administration & dosage/adverse effects
MH  - Propranolol/adverse effects/*therapeutic use
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Skin Neoplasms/congenital/*drug therapy/pathology
MH  - Treatment Outcome
EDAT- 2012/09/11 06:00
MHDA- 2013/08/08 06:00
CRDT- 2012/09/11 06:00
PHST- 2012/09/11 06:00 [entrez]
PHST- 2012/09/11 06:00 [pubmed]
PHST- 2013/08/08 06:00 [medline]
AID - 10.1111/j.1525-1470.2012.01846.x [doi]
PST - ppublish
SO  - Pediatr Dermatol. 2013 Jan-Feb;30(1):64-70. doi: 
      10.1111/j.1525-1470.2012.01846.x. Epub 2012 Sep 7.