Diagnosis and Management of Infantile Hemangioma

Table 38. Strength of evidence for effectiveness of laser modalities (continued)
Intervention
Cryotherapy
vs.
Observation
Photothermolysis
with Intense
Pulsed Light
With or
Without
Sclerosis vs.
Cryotherapy
Outcome
Study Design
Quality and Number
of Studies (N Total)
Improvement in IH
Comparative study
with treated/untreated
IH per child: 1 poor 220
(13)
Improvement in IH
Cohort studies: 1
poor 219 (250)
Study
Limitations
Consistency Directness Precision
Reporting
Bias
Finding
Strength of Evidence Grade
High Unknown Direct Imprecise NA 76% of IH in treated arm vs. 12% in
untreated resolved without scarring.
Insufficient SOE given single, small
study with high limitations.
High Unknown Direct Imprecise NA More children had ≥50% reduction
in IH size in the combined therapy
arm than in other arms (p=NR).
Insufficient SOE given single study
with high limitations.
CO2 = carbon dioxide; IH = infantile hemangioma; NA = not applicable; NR = not reported; Nd:YAG = neodymium yttrium aluminum garnet; PDL= pulse dye laser; QoL =
quality of life; RCT = randomized controlled trial
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