Plast Reconstr Surg. 2025 May 6. doi: 10.1097/PRS.0000000000012186. Online ahead of print.
ABSTRACT
BACKGROUND: Oral propranolol is the first-line treatment for problematic infantile hemangiomas (IHs) requiring systematic therapy. Several retrospective studies have reported the successful treatment of facial IHs with propranolol. In this study, we conducted a prospective trial to evaluate the long-term outcomes of oral propranolol use in patients with facial IHs.
METHODS: The primary outcome was the clinical response 4 years after treatment.
RESULTS: A total of 272 patients were analyzed, including 38 (14.0%) patients with ulcerated IHs. Four years after treatment, propranolol treatment had resulted in no/minimal sequelae in 232 patients (85.3%). A total of 265 (97.4%) patients reported a durable response to propranolol therapy. Major rebound occurred in 16.9% of patients after propranolol discontinuation. Additional surgery and laser treatment were required in 8.1% and 8.8% of patients, respectively. Logistic regression analyses revealed that age ≥ 3 months (95% confidence interval [CI], 1.488-31.023; P=0.013), nasal IH (95% CI, 2.143-97.571; P=0.006) and hemangioma ulceration (95% CI, 2.673-49.034; P=0.001) were independent factors predictive of long-term severe/significant sequelae. Segmental subtype (95% CI, 2.081-45.597; P=0.004), mixed IH (95% CI, 3.249-26.841; P<0.001) and lip IH (95% CI, 2.224-92.278; P=0.005) were independent risk factors for major rebound.
CONCLUSIONS: In this large cohort of patients with facial IHs, propranolol treatment was effective and induced no/minimal sequelae at 4 years after treatment. However, long-term severe/significant sequelae and major rebound after propranolol treatment remain challenges.
PMID:40327835 | DOI:10.1097/PRS.0000000000012186
