1.Demographic and clinical characteristics for infantile haemangioma in a tertiary centre in Malaysia
SY Ng ; SS Heah ; Sabeera BKI
Malaysian Journal of Dermatology 2011;27(-):7-7
Introduction: Infantile haemangioma is the most common tumor in infancy. They are extremely heterogenous clinically. Established risk factors for infantile haemangioma include female sex, white ethnicity, prematurity, low birth weight and multiple
gestation. There is a lack of demographic studies in the Asian population especially in the Malay ethnic group.
Objective: To describe the demographics and clinical characteristics of infantile haemangioma in a tertiary centre in Malaysia. To describe associated complications and the need for therapeutic intervention. To determine whether there is any difference
in demographics and clinical characteristics of infantile hemangiomas in a Malaysian population comprising predominantly Malay ethnic group with published reports of Western population. Design Retrospective review of patients with infantile haemangioma referred to the Paediatric Dermatology unit, Kuala Lumpur
Hospital between January 2009 and May 2011.
Main Outcome Measures: Demographic and clinical characteristics were summarized and compared with data from previous studies. The study
included 50 patients (38 females and 12 males) with a mean age of 6.23 months (range 0.1 to 16 months) at presentation. 11(22%) patients were premature. The mean age of onset was 20 days (range 0 to 5 months). 18(37%) patients had a premonitory mark at birth.
Of 62 hemangiomas in 50 patients, 45(72.5%) were localized, 5(8.1%) were segmental, 11(17.7%) indeterminate and 1(1.6%) multifocal. The most frequent location of the haemangiomas was in the face with 29(46.8%) lesions, followed by 10(16.1%) lesions in the head and neck, 10(16.1%) lesions in the extremities, 8(12.9%) lesions in the trunk and 5(8.1%) in the perineum. Complications that occurred included ulceration in 8(16%) patients, threat to vision in 7(14%), infection in 2 (4%) and bleeding in 6(12%) patients. Of the 50 patients, 24(48%) patients required interventions. These interventions included propranolol only in 12(24%) patients, prednisolone only in 4(8%), both propranolol and prednisolone in 5(10%), wound care in 2(4%) and pulse dye laser in 1(2%).
Conclusion: The demographics and clinical characteristics of infantile haemangiomas in Malaysia are similar to published reports.
2.A retrospective observational study of propanolol use in the treatment of infantile haemangioma: A single centre experience
Heah SS ; Ng SY ; Leong KF ; Sabeera Begum
Malaysian Journal of Dermatology 2011;27(-):15-15
Introduction:
Infantile haemangioma (IH) is a common benign vascular tumour which is characterised by rapid proliferation in early infancy period followed by slow involution for years. The initial rapid growth and the location of haemangioma may result in significant morbidity. The introduction of oral Propranolol for the treatment of IH in recent years has seen many promising results though with potential risks.
Objective:
To review the demography, clinical pattern, management and outcome of patients with IH treated with propranolol in a
paediatric dermatology referral centre.
Methodology:
A retrospective observational study of medical records of patients with IH treated with oral propranolol (maximum dose 2mg/kg/day) from May 2009 to May 2011 in Paediatric Institute, Kuala Lumpur Hospital.
Results:
A total of 17 patients (14 girls, 3 boys) were studied. They were 12 Malays (70.6%), 2 Chinese(11.8%), 2 Indians(11.8%) and 1 Indonesian (5.9%). Mostly term babies (88%). The age of presentation is from birth to 2 months old. The location of haemangiomas involve periocular (35.3%), perioral (17.6%), facial segmental (17.6%), nasal (5.9%), multiple (17.6%) and spinal (5.9%). They were started on Propranolol at a mean age of 5 months old except one at 2 years old. Five patients had concurrent adjunctive therapies. 70.6% had significant reduction of the size and colour of haemangiomas, 11.8% not significant, 11.8% unclear, and one patient defaulted follow up. Some patients developed wheezing episodes (29.4%),
diarrhoea (17.6%), regurgitation (5.9%); but no serious consequences.
Conclusion:
Low dose oral propranolol is a safe and effective treatment with minor side effects from our experience.