Two-year propranolol treatment recommended for segmental facial hemangiomas

Propranolol treatment for a duration of two years is recommended for patients with segmental facial hemangiomas, according to a research letter published in the Journal of the American Academy of Dermatology.

“About 10% of infantile hemangiomas are located on the face. They can be subdivided into focal (FHH) and segmental facial hemangiomas (SFH),” Florian Schmid, MD, and Peter H. Hoeger, MD, of the Catholic Children’s Hospital Wilhelmstift in Hamburg, Germany, wrote.

Researchers conducted a retrospective case-control study of 52 SFH patients and 108 age-matched patients with FFH who received oral propranolol therapy of 2 mg to 2.5 mg per kg of body weight per day for 6 months, with monthly dose adjustments.

Until objective evidence of growth or relapse was assessed, treatment continued with permanent discontinuation occurring when there was no regrowth after 3 months of drug discontinuation.

Patients with SFH had a significantly longer duration of therapy (382 vs. 190 days) and significantly higher relapse rates (OR = 11.4; 95% CI, 4.9-26.9) compared with those with FHH.

Treatment for more than 2 years and up to 5.5 years was needed in 20% of SFH patients.

“Our results indicate that 80% of children with SFH achieved recurrence-free remission after a total of 23.3 months,” the authors wrote. “We thus recommend to treat children with SFH initially for 2 years.”

Further studies were also recommended to determine if a 24-month continual treatment is better than the current practice 6-month to 12-month treatments with retreatments upon recurrence.