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Pediatr Clin North Am. 2014 Apr;61(2):383-402. doi: 10.1016/j.pcl.2013.11.010. Epub 2014 Feb 18.

Diagnosis and management of infantile hemangiomas.

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Division of Pediatric Dermatology, Department of Dermatology, Johns Hopkins University School of Medicine, 200 North Wolfe Street, Unit 2107, Baltimore, MD 21287, USA. Electronic address:


Propranolol has replaced corticosteroids as preferred first-line therapy for the management of infantile hemangiomas (IH). The topical β-blocker timolol is now an alternative to oral propranolol and watchful waiting for smaller IH. Research in the last decade has provided evidence-based data about natural history, epidemiology, and syndromes associated with IH. The most pressing issue for the clinician treating children with IH is to understand current data to develop an individualized risk stratification for each patient and determine the likelihood of complications and need for treatment. This article emphasizes the nuances of complicated clinical presentations and current treatment recommendations.


Infantile hemangioma; PHACE syndrome; Propranolol; Timolol; β-Blocker

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