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Comment
. 2022 Aug 1;48(8):833-837.
doi: 10.1097/DSS.0000000000003491. Epub 2022 May 17.

Clinical Outcomes of Small Infantile Hemangiomas Treated With Pulsed Dye Laser

Misako Nakazono  1 , Shintaro Kagimoto  1 , Tomoyuki Koike  1 , Toshihiko Satake  2 , Jiro Maegawa  3
Affiliations
Comment

Clinical Outcomes of Small Infantile Hemangiomas Treated With Pulsed Dye Laser

Misako Nakazono et al. Dermatol Surg. .

Abstract

Background: Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of Pediatrics' Clinical Practice Guideline. Conversely, strategies for the management of small, low-risk lesions have not been established; however, pulsed dye laser (PDL) is often used to treat these lesions.

Objective: To investigate clinical outcomes of PDL in small IH lesions.

Patients and methods: Fifty-three cases with 58 small IHs which did not meet the criteria for high-risk lesions in the guideline and were treated only with PDL were retrospectively reviewed. The characteristics of IHs and residual skin changes after treatment were evaluated.

Results: Forty-seven lesions (81.0%) were superficial hemangiomas, whereas 11 (19.0%) were combined-type. The median maximum diameter was 10.0 mm. Forty-five lesions (77.6%) exhibited various residual skin changes after PDL treatment, including anetoderma (53.5%), telangiectasia and erythema (43.1%), hyperpigmentation (34.5%), redundant skin (3.4%), and fibrofatty tissue (3.4%). Of these, the incidence of anetoderma and fibrofatty tissue were significantly higher in the combined group than in the superficial group ( p = .036 and .033, respectively).

Conclusion: Even small lesions, especially combined-type, often result in cosmetic problems after PDL treatment.

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Comment on

  • Clinical Practice Guideline for the Management of Infantile Hemangiomas.
    Krowchuk DP, Frieden IJ, Mancini AJ, Darrow DH, Blei F, Greene AK, Annam A, Baker CN, Frommelt PC, Hodak A, Pate BM, Pelletier JL, Sandrock D, Weinberg ST, Whelan MA; SUBCOMMITTEE ON THE MANAGEMENT OF INFANTILE HEMANGIOMAS. Krowchuk DP, et al. Pediatrics. 2019 Jan;143(1):e20183475. doi: 10.1542/peds.2018-3475. Pediatrics. 2019. PMID: 30584062 Review.

References

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