From Our 2008 Archives

Beta Blocker May Shrink Infant Hemangiomas

By Serena Gordon
HealthDay Reporter

WEDNESDAY, June 11 (HealthDay News) — New research suggests that a blood pressure medication can shrink abnormal and sometimes disfiguring growths of blood vessels in infants known as hemangiomas.

When using propranolol to treat heart conditions in two infants who also had a hemangioma, French researchers noticed that the color and size of the hemangioma was reduced within a day for both babies.

"We have serendipitously observed that propranolol can inhibit the growth phase of infant hemangioma in two consecutive infants," said Dr. Christine Leaute-Labreze, from the department of pediatric dermatology at Bordeaux Children's Hospital in France.

"After informed consent was obtained from the parents, propranolol was given to nine additional patients who had severe or disfiguring infant hemangiomas. In all cases, 24 hours after the onset of treatment, we observed a change in color from intense red to purple, associated with a palpable softening of the lesion," she said.

Results of the study were published as a letter in the June 12 issue of the New England Journal of Medicine.

Hemangiomas, commonly seen as red lesions, are usually found in the top layers of the skin, but sometimes, they grow much deeper. Although they're noncancerous, they can be disfiguring.

Most hemangiomas grow for about nine months, according to Dr. Robin Gehris, chief of pediatric dermatologic surgery at Children's Hospital of Pittsburgh. "Their natural history is that they behave similar to placental tissue. They actively proliferate for about nine months, then stabilize, and then [decrease] about 10 percent a year until they're gone," she said, adding that without treatment most are gone by the time a child is 10.

If a hemangioma is growing near the eye, mouth or airway, Gehris said that treatment will often be given. The most common treatment for more serious hemangiomas is corticosteroids. Other medications that can be used include vincristine (a chemotherapy medication) and interferon.

Propranolol is a blood pressure-lowering medication from a class of medications called beta blockers. Beta blockers aren't advised for people with asthma, diabetes or a known heart blockage, according to Leaute-Labreze. She said none of the infants had serious side effects from propranolol, though some experienced low blood pressure.

Because all of the currently used medications have side effects, some serious, Gehris said the idea that propranolol could be used is an "enticing, interesting idea, because we're always looking for safer and more effective treatments."

But, she added, this study was done on a very small number of children, and it wasn't placebo-controlled. Additionally, in at least some of the cases, infants had already been given steroids, so, Gehris said, it's possible the reaction attributed to propranolol might have been a delayed reaction to the steroids.

Leaute-Labreze said that the researchers plan on conducting further research to further assess propranolol's effect on hemangiomas, and the authors of the study have applied for a patent on the use of beta blockers for the treatment of infant hemangioma.

"Propranolol may constitute a reasonable, safe alternative to systemic corticosteroids, and even to interferon or vincristine in severe infant hemangioma. However, the risk/benefit ratio of this treatment should be evaluated in non-alarming, cosmetically impairing infant hemangiomas," Leaute-Labreze said.

SOURCES: Christine Leaute-Labreze, M.D., department of pediatric dermatology, Bordeaux Children's Hospital, and The National Center for Rare Skin Disorders of Bordeaux, France; Robin Gehris, chief, pediatric dermatologic surgery, Children's Hospital of Pittsburgh; June 12, 2008, New England Journal of Medicine

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