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Eur J Pediatr. 2015 Nov;174(11):1503-9. doi: 10.1007/s00431-015-2561-1. Epub 2015 May 16.

Therapeutic superiority of combined propranolol with short steroids course over propranolol monotherapy in infantile hemangioma.

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Pediatric Surgery Department, Ain Shams University, Cairo, Egypt.
Pediatric Surgery Department, Ain Shams University, Cairo, Egypt.
Pediatric Surgery Department, Ain Shams University, Cairo, Egypt.
Pediatric Surgery Department, Ain Shams University, Cairo, Egypt.
Radiodiagnosis Department, Ain Shams University, Cairo, Egypt.
Hematology-Oncology Unit, Pediatric Department, Ain Shams University, Abbasseya Square, Cairo, Egypt.


Infantile hemangiomas are the most common benign childhood tumor that may have functional and/or cosmetic complications. We aimed to compare the clinical efficacy of propranolol alone and propranolol primed with systemic corticosteroids on the outcome of infantile hemangioma. A prospective randomized study included 40 infants aged less than 9 months with cutaneous hemangiomas. Patients were randomly assigned into two groups: group A were given oral prednisolone for the initial 2 weeks combined with oral propranolol, while group B were given oral propranolol alone for 6 months. The median age of the studied patients was 4.5 months (ranged 4 weeks-8 months). Sequential determination of the dimensions of the hemangiomas based on direct measurement and photographic analysis were performed. A significant reduction in the size of the lesions was found in group A in the 2-, 4-, and 8-week evaluation compared to group B (p < 0.001) with no statistical difference in the ultimate 6 month response (p = 0.134). Multiple logistic regression showed that early treatment before 6 months of age (OR 9.82, p = 0.007) and combined treatment with propranolol and prednisolone (OR 10.71, p = 0.006) were the predictors of best response.


Combining propranolol with corticosteroids gives a faster response and should be considered in treating life- or function-threatening hemangiomas.


Combined treatment; Infantile hemangioma; Propranolol

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