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Drug Effective for Severe Hemangiomas in Children

Propranolol decreases redness and softens and flattens the benign tumors

WEDNESDAY, June 11 (HealthDay News) -- Propranolol is effective in treating severe capillary hemangiomas in children, relieving redness, and softening and flattening the lesions, according to an article in the June 12 issue of the New England Journal of Medicine.

Christine Leaute-Labreze, M.D., from Bordeaux Children's Hospital in France, and colleagues describe treating 11 children with severe or disfiguring infantile capillary hemangiomas with propranolol, a non-selective beta-blocker.

The researchers found that in all cases, the hemangiomas changed from red to purple and softened within 24 hours of starting treatment. They continued to improve until they were nearly flat, with residual skin redness. Ultrasonography of five patients showed a reduction in hemangioma thickness and an increase in its resistive index of vascularization. In at least two of the patients, the hemangioma did not recur after stopping corticosteroid treatment.

"Potential explanations for the therapeutic effect of propranolol -- a non-selective beta-blocker -- on infantile capillary hemangiomas include vasoconstriction, which is immediately visible as a change in color, associated with a palpable softening of the hemangioma; decreased expression of VEGF and bFGF genes through the down-regulation of the RAF-mitogen-activated protein kinase pathway (which explains the progressive improvement of the hemangioma); and the triggering of apoptosis of capillary endothelial cells," the authors write.

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