We thank you for the opportunity to respond to Dr Zheng’s letter regarding our article,
Low-Dose Propranolol for Infantile Haemangioma.
1
The serendipitous discovery of accelerated involution of infantile haemangioma induced
by propranolol
2
and acebutalol
3
has resulted in a paradigm shift in the management for this condition. This mirrors
the previous serendipitous observation of the effect of high dose steroids on infantile
haemangioma
4
which naturally invited logical questions on the (1) mechanism of action; (2) the
optimal dose regimen and duration of treatment; and (3) the side effects of treatment
in infants and young children with problematic infantile haemangioma. Over the last
40 years, some of these questions have been answered and the dose regimen settled
on 2–3 mg/kg/day
5
but the mechanism of action of steroid therapy remains incompletely elucidated with
induced apoptosis through the up-regulation of mitochondrial cytochrome b gene being proposed.
6
,
7
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Low-dose propranolol for infantile haemangioma.Plast Reconstr Surg. 2010; 64: 292-299
- Propranolol for severe hemangiomas of infancy.N Engl J Med. 2008; 358: 2649-2651
- Beta-blocking agent for the treatment of infantile hemangioma.Plast Reconstr Surg. 2009; 123: 195e-196e
- Induced resolution of cavernous hemangiomas following prednisolone therapy.Plast Reconstr Surg. 1967; 39: 76-83
- Complications of systemic corticosteroid therapy for problematic hemangioma.Plast Reconstr Surg. 1999; 104: 1616-1623
- Steroid therapy of a hemangioma: histochemical and molecular changes.Pediatrics. 2000; 105: 117-121
- Altered mitochondrial cytochrome b gene expression during the regression of hemangioma.Plast Reconstr Surg. 2001; 108: 1471-1476
- Comparative β-adrenorecptor blocking effects of propranolol, bisoprolol, atenolol, acebutalol and diacetolol on the human isolated bronchus.Br J Clin Parmac. 1990; 30: 135-139
- Primitive mesodermal cells with a neural crest stem cell phenotype predominate proliferating infantile haemangioma.J Clin Pathol. 2010; 63: 771-776
- Haemogenic endothelium in infantile haemangioma.J Clin Pathol. 2010; 63: 982-986
- Expression of components of the renin-angiotensin system in proliferating infantile haemangioma may account for the propranolol-induced accelerated involution.Plast Reconstr Aesthet Surg. 2010; 64: 759-765
- Propranolol for infantile haemangiomas:insights into the molecular mechanisms of action.Brit J Dermatol. 2010; 63: 269-274
- Propranolol in children: safety-toxicity.Pediatrics. 1982; 70: 30-31
- More on propranolol for hemangiomas of infancy.N Engl J Med. 2008; 359: 2846-2847
- Hypoglycaemia in children taking propranolol for the treatment of infantile haemangioma.Arch Dermatol. 2010; 146: 775-778
- Severe hypoglycaemia during successful treatment of diffuse hemangiomatosis with propranolol.Pediatr Dermatol. 2010; 27: 195-196
- Propranolol for severe infantile hemangiomas: follow-up report.Pediatrics. 2009; 124: e423-e431
- Role of propranolol in the therapeutic strategy of infantile laryngotracheal hemangioma.Int J Pediatr Otorhinolaryngol. 2009; 73: 1168-1172
- Propranolol for complicated infantile haemangiomas: a case series of 30 infants.Brit J Dermatol. 2010; 162: 452-468
- Management of complicated facial hemangiomas with [beta]-blockers (propranolol) therapy.Plast Reconstr Surg. 2010; 126: 889-895
- Pharmacokinetics of propranolol after single and multiple dosing with sustained release propranolol or propranolol (innopran XL), a new chronotherapeutic formulation.Heart Dis. 2003; 5: 176-181
- More on propranolol for hemangiomas of infancy.N Engl J Med. 2008; 359: 2846-2847
- Treatment of infantile hemangioma with captopril.Brit J Dermatolol. 2012; (Accepted)
Article info
Publication history
Published online: January 24, 2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Recognising phenytoin therapy as a cause of thickening of the eyelids and paranasal regionJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 64Issue 12
- PreviewWe present a 55 year old female, with gradual painless thickening of her eyelids and nose over several months, who requested aesthetic surgery to correct these changes. One-year prior to this she had undergone a craniotomy and debulking of an olfactory groove meningioma and commenced on prophylactic phenytoin therapy. On examination she was found to have a widened nasal bridge and soft-tissue thickening of the glabellar region and medial canthi. (Figure 1a). Her paranasal and eyelid thickening was presumed to be phenytoin-related and under the supervision of her neurologist this was tailed off.
- Full-Text
- Preview
