Combination of oral corticosteroids and polidocanol sclerotherapy in the management of infantile hemangiomas.

BACKGROUND

Infantile hemangiomas (IHs) are the most common benign tumors of infancy and may need to be treated in some cases. Oral corticosteroids are the mainstay of therapy but are not without their attendant side effects.

OBJECTIVES

To evaluate the efficacy of combination therapy with oral corticosteroids and polidocanol sclerotherapy in hemangiomas needing treatment.

PATIENTS AND

METHODS

Eight children with IHs were started on oral prednisolone 3 to 4 mg/kg per day and fortnightly sclerotherapy with 3% polidocanol solution. The outcome was evaluated on the basis of color, turgidity of the lesion, ongoing growth, and assessment by parents and physician. Serial photographic records were maintained. The response was graded as excellent, good, poor, or nil. Complications were recorded.

RESULTS

Four male and four female patients presented at a mean age of 4.6 months. The average area of the lesions was 40.6 cm(2) . The mean duration of treatment with steroids at full dose was 8.2 weeks and mean total duration of treatment was 28.6 weeks. Mean number of sclerotherapy sessions required was 4.7. Complications included ischemic necrosis, rebound growth, and ulceration.

CONCLUSION

Combining oral corticosteroids with polidocanol sclerotherapy produced excellent results in the patients treated, with minimal attendant side effects.