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| LETTER TO EDITOR |
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| Year : 2000 | Volume
: 66
| Issue : 3 | Page : 162 |
Haemangioma : Treatment with Corticosteroid (le)
Namita Rath, HK Kar
,
Correspondence Address:
Namita Rath
PMID: 20877067
How to cite this article:
Rath N, Kar H K. Haemangioma : Treatment with Corticosteroid (le). Indian J Dermatol Venereol Leprol 2000;66:162 |
To the Editor
Strawberry haemangioma is a common vascular tumour of infancy. It presents either at birth, or more frequently, within the first two weeks of life. It may occur anywhere in the skin and the common sites are head and neck. It starts as a pale macule or group of telangiectatic vessels and gradually develops into a bright red or purple nodular mass. Histologically it is a congenital dense diffuse proliferation of endothelial cells of capillaries and venules throughout the reticular dermis and subcutaneous fat. [1] It proceeds through different stages, a growth phase, during the first year of life, a sTable period followed by involution, in the course of months or years. Large haemangiomas may interfere with vital functions such as feeding, respiration and vision. [2]
Several modalities of treatment have been advocated for complicated haemangiomas. Oral steroid is the mainstay of treatment for rapidly growing and ulcerated strawberry haemangiomas. Daily dose of prednisolone (2-4 mg/kg) induces cessation of growth in less than three weeks. The treatment should be continued for 30 to 90 days depending on response.' Alternate day steroids have also been used. Infants tolerate this type of therapy remarkably well, and it is unusual to find any adverse effects. [3]
A two month old female child presented with a strawberry haemangioma, of dimensions of 7 cm x 7cm, over right cheek with extensive central ulceration and bleeding. It obstructed the vision of the right eye and caused difficulty in breast feeding. Initially a small macule was present at birth over the right cheek, which became nodular within 7 days and rapidly progressed to present size within 15 days. Ophthalmic examination of the right eye was normal. The platelet count was within normal limits. The patient was placed on 40mg prednisolone on alternate days (A/D) for two weeks, 20 mg A/D for further two weeks. The dose was tapered to 10 mg A/D for next two weeks and finally 5 mg A/D for the subsequent month. The haemangioma lightened in colour within the first week. The ulcer healed in two weeks. There was flattening of the lesion in four weeks and reduction in size after ten weeks of therapy. There was no longer any obstruction to vision and feeding.
In our case the lesion showed reduction in size with flattening after ten weeks of steroid therapy. Thus this form of treatment can be routinely employed in complicated haemangiomas in order to ensure promising results
| References | |  |
| 1. | Fitzpatrick TB, Eisen AZ, Wolf K, et al. Vascular proliferation of skin and subcutaneous fat. In: Dermatology In General Medicine, 4 thsub edn Mc Graw-Hill, New York, 1993; 1234-1236.  |
| 2. | Bowers RE, et al. The natural history of the strawberry nevus. Arch Dermatol 1960; 82: 667. |
| 3. | Zarem HA, Edgerton MT. Induced resolution of cavernous hemangiomas following prednisolone therapy. Plast Reconstructive surgery 1967; 39: 76-83. |
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