Evaluation of topical steroids in the treatment of superficial hemangioma.

Infantile hemangioma is a common disease. Steroids have been used for its treatment; however, intralesional steroids cause pain and other problems. A treatment modality that can avoid these problems is desirable. The authors evaluated the role of topical steroids as an alternative to intralesional steroids in the treatment of superficial hemangioma. Inclusion criteria were <2 superficial type ofhemangiomas <5 cm. The topical steroid mometasone furoate was applied twice daily. Intralesional triamcinolone acetonide was injected at monthly intervals using a 24-gauge needle at doses of 1 to 2 mg/kg. Forty-five (86.5%) patients responded to treatment with the topical steroids, of which 50% had excellent and 36.5% had good response. In the intralesional group, the response rate was 95.7%, of which 63.8% had excellent and 31.9% had good response. Complications in the topical steroid group were mild itching and irritation (19.2%) and hypopigmentation (7.6%). Complications in the intralesional group were pain (100%), bleeding (17%), infection (17%), cutaneous atrophy (8.5%), cushingoid facies (2.1%), and growth retardation (2.1%). Topical steroids are a reasonably good alternative to intralesional steroids as an initial choice for treating superficial hemangioma.