Atopic Dermatitis: a Short Summary
Poster: Utility of Associating Propanolol To The Pulse Dye Laser For The Treatment Of Ulcerated Hemangiomas (For Professionals)
Observations: Study of two cases
–Case no 1: female baby of two months of age presenting with an ulcerated hemangioma on the back measuring 10 x 6 cm painful treated by PDL (V-star, 8J/cm2), length of pulse 0.5ms, spot size 10mm). Associated with this was an oral treatment of propanolol 2mg/Kg/day (following cardiac screening: blood pressure, ECG, cardiac ultrasound). Following this, a disappearance of pain occured after 3 weeks of treatment and complete healing (with a scar) after 6 weeks. 3 months after stopping propanolol, the pain came back and the hemangioma started growing again. The reintroduction of propanolol permitted a regression of the lesion (time lapse not specified).
–Case no 2 : male baby of 5 months with a hemangioma on the right forearm, measuring 5cm of diameter with a central ulceration of 3cm of diameter. The lesion is painful and infected. With sinmilar settings, than in case 1, PDL was used, but with the persistance of the lesion, propanolol was given followed by the disappearance of pain and healing (with scar formation) in 4 weeks.
Discussion
-These are the first cases according to the authors associating PDL with beta-blocking drugs.
-PDL lasers have a hemostatic, pain relieving action and they accelerate wound healing.
-Beta-blocking drugs enable hemangioma regression (1). They are tolerated better than oral steroids and interferon therapy.
Conclusion : these observations support the role of propanolol in the treatment of ulcerated hemangiomas by enhancing their regression.
1 : Léauté-Labrèze et al, Propanolol for severe hemangoioma of infancy, NEJM 2008; 358, 2649-51
Declared conflicts of interest: none mentioned on the poster
Contributors:
Dr Christophe HSU – dermatologist. Geneva, Switzerland
Source of information (French): Poster (Naouri M et al.). Journées Dermatologiques de Paris 2009.
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