Diagnosis and Management of Infantile Hemangioma

Table 6. Key resolution outcomes in studies comparing intralesional and topical corticosteroids
Age at
Initiation,
Months Location
Resolution Outcomes
Author, Year
Comparison
Groups (n)
Quality
Pandey et al.
2010 122
G1:
Mometasone
furoate,
topical thin
film applied
twice daily
(52)
G2:
Triamcinolone
acetonide,
intralesional
1-2 mg/kg
(47)
Age
NR
Type
Type, %
Superficial:100
NR
Measures of
Resolution/Response
• Cessation of growth,
lightening of color, and
flattening of surface
• Positive response in all 3
parameters=Excellent
• Positive response in 2
parameters=Good
• Response in single or no
parameter=Poor
• Blinded assessment: NR
Quality: Fair
G = group; IH = infantile hemangioma; kg = kilogram; mg = milligram; n = number; NR = not reported
Response rate, n (%)
Excellent
G1: 26 (50)
G2: 30 (63.8)
Good
G1: 19 (36.5)
G2: 15 (31.9)
Poor
G1: 7 (13.4)
G2: 2 (4.2)
Methylprednisolone Versus Prednisolone
In one fair quality Turkish retrospective cohort study, 283 of 1,109 children with superficial
(53.7%), deep (18.8%), or mixed (16%) IH seen over 23 years at one hospital received either
observation (n=238), 2 mg/kg/day prednisolone (n=26, median age at initiation=5 months),
10mg/kg/day methylprednisolone (n=11, median age at initiation=6 months), or
methylprednisolone tapered from 30 mg/kg/day to 10 mg/kg/day for 7 days (n=8, median age at
initiation=7 months). 40 Among the children in the observation group at a median of 2 years of
followup, 92 had complete or near complete (75-100%) regression, 37 had 50 to 75 percent
regression, 20 had 25 to 50 percent regression, and 89 had less than 25 percent regression. By
age 5, 68 percent out of an unstated number of children followed had complete regression, and
90 percent of 92 children followed had complete regression by age 9. Overall, 16 children (36%)
had a good or excellent response to steroids; 15 (33%) had a fair response; and 14 (31%) had
poor response. Response did not differ significantly among or between the three groups, but
rebound growth was significantly higher (p=0.045) among those receiving methylprednisolone
(dose not clearly reported, n=8 with rebound growth) compared with prednisolone (n=4 with
rebound growth). Table 7 outlines resolution outcomes.
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