Because of the spontaneous involution, most IHs do not require treatment, but about 10% of cases require early treatment due to size, location, and complications. IHs are clinically characterized by a proliferative phase followed by an involutive phase. Pathologically, IHs are glucose transporter-1 protein (GLUT-1)–positive, the expression of which distinguishes them from other vascular tumors or vascular malformations. Infantile hemangiomas (IHs) are the most common vascular tumor and the most common benign tumor of infancy, developing in 5%–10% of infants. Key words: Hemangioma, Propranolol, Vascular disease, Vascular malformation
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Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.
Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1–2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2–3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. Approximately 10% of IH cases require early treatment. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%–10% of infants. The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations.
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