Prognostic Factors for Long-term Aesthetic Outcome of Infantile Haemangioma Treated with Beta-blockers

Authors

  • Mireille M. Hermans Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Dermatology – Center of Pediatric Dermatology, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands
  • Suzanne G.M.A. Pasmans Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Dermatology – Center of Pediatric Dermatology, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands
  • Marlies de Graaf Department of Dermatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, UMC Utrecht Center for Vascular Anomalies, The Netherlands
  • Aviël Ragamin Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Dermatology – Center of Pediatric Dermatology, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands
  • Elodie J. Mendels Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Dermatology – Center of Pediatric Dermatology, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands
  • Johannes M.P.J. Breur Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands
  • Hester R. Langeveld Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Intensive Care and Pediatric Surgery, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands
  • Martine F. Raphael Department of Dermatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, UMC Utrecht Center for Vascular Anomalies, The Netherlands
  • Peter C.J. de Laat Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Pediatrics (-Hemato-oncology), Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands
  • Saskia N. de Wildt Department of Pharmacology and Toxicology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
  • André B. Rietman Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Child and Adolescent Psychology/Psychiatry, the Netherlands
  • Corstiaan C. Breugem Department of Plastic Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht, UMC Utrecht Center for Vascular Anomalies, The Netherlands
  • Renske Schappin Department of Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands

DOI:

https://doi.org/10.2340/actadv.v103.5286

Keywords:

Vascular tissue neoplasms, Adrenergic beta-antagonists, Infant, Esthetics, Cicatrix, Telangiectasis

Abstract

Parents of infants treated with beta-blockers for infantile haemangioma are often concerned about the long-term aesthetic outcome. This cross-sectional study assessed the influence on the long-term aesthetic outcome of characteristics of the infantile haemangioma, the beta-blocker treatment, and the infant. The study included 103 children aged 6–12 years, treated with beta-blockers (propranolol or atenolol) for infantile haemangioma during infancy (age at treatment initiation ≤1 year) for ≥6 months. Dermatologists and parents scored the Patient Observer Scar Assessment Scale, and the child scored a visual analogue scale. Dermatologists identified whether telangiectasia, fibrofatty tissue, and atrophic scar tissue were present. The long-term aesthetic outcome of infantile haemangioma was judged more negatively by dermatologists and parents in case of a superficial component, ulceration, older age at treatment initiation, higher cumulative dose, and/or shorter follow-up time. According to children, infantile haemangioma located on the head had better aesthetic outcome than infantile haemangioma located elsewhere. Close monitoring, particularly of infantile haemangioma with a superficial component, is essential for early initiation of treatment, and to prevent or treat ulceration. These outcome data can support parental counselling and guide treatment strategy.

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Author Biographies

Suzanne G.M.A. Pasmans, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Dermatology – Center of Pediatric Dermatology, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands

Suzanne G.M.A. Pasmans and Marlies de Graaf contributed equally as co-second authors. 

Marlies de Graaf, Department of Dermatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, UMC Utrecht Center for Vascular Anomalies, The Netherlands

Suzanne G.M.A. Pasmans and Marlies de Graaf contributed equally as co-second authors.

Martine F. Raphael, Department of Dermatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, UMC Utrecht Center for Vascular Anomalies, The Netherlands

Current affiliation: Department Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, The Netherlands

Corstiaan C. Breugem, Department of Plastic Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht, UMC Utrecht Center for Vascular Anomalies, The Netherlands

Corstiaan C. Breugem and Renske Schappin contributed equally as co-last authors.

Current affiliation: Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, University of Amsterdam, The Netherlands

Renske Schappin, Department of Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands

Corstiaan C. Breugem and Renske Schappin contributed equally as co-last authors.

Current affiliation: Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Department of Dermatology – Center of Pediatric Dermatology, Center of Rare Skin Diseases, Vascular Anomaly Center Erasmus MC Rotterdam, member of the ERN-SKIN-Mosaic group and ERN-VASCERN-VASCA group, The Netherlands

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Published

2023-08-30

How to Cite

Hermans, M. M. ., Pasmans, S. G., de Graaf, M., Ragamin, A., Mendels, E. J., Breur, J. M., Langeveld, H. R., Raphael, M. F., de Laat, P. C., de Wildt, S. N., Rietman, A. B., Breugem, C. C., & Schappin, R. (2023). Prognostic Factors for Long-term Aesthetic Outcome of Infantile Haemangioma Treated with Beta-blockers. Acta Dermato-Venereologica, 103, adv5286. https://doi.org/10.2340/actadv.v103.5286

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Vol. 103 (2023)

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Copyright (c) 2023 Mireille M. Hermans, Suzanne G.M.A. Pasmans, Marlies de Graaf, Aviël Ragamin, Elodie J. Mendels, Johannes M.P.J. Breur, Hester R. Langeveld, Martine F. Raphael, Peter C.J. de Laat, Saskia N. de Wildt, André B. Rietman, Corstiaan C. Breugem, Renske Schappin

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