Efficacy and Safety of Oral Propranolol or Topical Timolol for the Treatment of Superficial Infantile Hemangiomas.

Infantile hemangiomas (IHs) are the most common benign soft tissue tumors of infancy. Oral propranolol has become a first-line treatment option since the unexpected discovery of its surprising efficacy in the treatment of IHs in 2008. However, oral propranolol causes systemic complications, including hypotension, bradycardia, and hypoglycemia. To minimize systemic adverse effects of oral propranolol, timolol maleate, a nonselective ß-blocker similar to propranolol, has been used as a topical agent to treat superficial IHs. The authors evaluated the efficacy and safety of oral propranolol or topical timolol in 60 patients with IHs. Of the 60 patients recruited, 30 patients were treated using orally administrated propranolol and an additional 30 patients received topical timolol. The efficacy rate of the oral propranolol and topical timolol was 96.7% and 93.3%, respectively. There were no significant differences between the two treatment patterns for the efficacy rate. The incidence of systemic adverse effects for patients treated with oral propranolol was significantly higher than that for cases received topically timolol treatment. Topical timolol maleate is effective and well-tolerated in the treatment of IHs. It could be considered as the first-line treatment choice, especially for superficial IHs.

[The efficacy of treatment of oral and maxillofacial venous malformations by pingyangmycin injection with different concentrations].

PURPOSE: To evaluate the clinical effect of using different concentrations of pingyangmycin to treat venous malformations in oral and maxillofacial region. METHODS: One hundred and ninety-four patients with venous malformations in oral and maxillofacial region were included and treated by pingyangmycin injection with different concentrations. For superficial cutaneous venous malformations, the concentration of pingyangmycin was 8mg/mL while 8mg/5mL for venous malformations limited to oral mucosa or submucosa. RESULTS: The efficient of cutaneous venous malformations was 94.9%,while 100% for oral mucosal and submucosa. CONCLUSIONS: Using different concentrations of pingyangmycin for venous malformations in different sites can get good results and reduce unnecessary complications.

[Intralesional pingyangmycin injection in the management of macrocystic lymphatic malformations in cervical region].

PURPOSE: To investigate the therapeutic effects of pingyangmycin injection as a primary therapy of macrocystic lymphatic malformations in cervical region. METHODS: Thirty-six patients with macrocystic lymphatic malformations in cervical region underwent the therapy of pingyangmycin injection between 2009 and 2012 at School of Stomatology, China Medical University. Among them, 16 patients had unilateral submandibular lesions, 20 patients had lesions in anterior cervical regions. The age of patients was from 6 months to 25 years old. The concentration of the drug was 1.6 mg /mL with an addition of lidocaine. The dose and cycle of treatment were dependent on the lesions' size and patients' age. The follow-up period was 12 months to 2 years after the last treatment. RESULTS: The total effective rate was 100%, and the curative rate was 94.4%. No serious complications were encountered. CONCLUSIONS: Intralesional Injection of pingyangmycin provides a safe and effective treatment for macrocystic lymphatic malformations in cervical region as a primary treatment.

Propranolol given orally for proliferating infantile haemangiomas: analysis of efficacy and serological changes in vascular endothelial growth factor and endothelial nitric oxide synthase in 35 patients.

We investigated the clinical efficacy of propranolol in treating proliferating infantile haemangiomas, and the serological changes in vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) during treatment. Propranolol was given orally to 35 infants with proliferating haemangiomas in a dose of 1.0-1.5mg/kg/day. Hemisphere measurements, the 4-score method, and feedback from parents were used to evaluate the clinical curative effects. An ELISA was used to measure the serum concentrations of VEGF and eNOS before, and 1 and 2 months after, treatment. The response was excellent in 6 patients, good in 16, moderate in 10, and poor in 3. The peripheral serum concentrations of VEGF and eNOS 2 months after treatment were significantly lower than those before treatment (p<0.01). We conclude that propranolol can be safely and effectively used to treat proliferating infantile haemangiomas. It can reduce the peripheral serum concentrations of VEGF and eNOS in affected children.

[Electrochemical therapy combined with pingyangmycin injection in the management of high-return flow venous malformation].

OBJECTIVE: To investigate the clinical effect of electrochemical therapy (ECT) combined with pingyangmycin (PYM) injection for the treatment of high-return flow venous malformation. METHODS: A total of 68 cases of the high-return flow venous malformation were retrospectively analyzed, in which 32 cases received simplely ECT,and 36 cases received ECT combined with PYM injection. The patients were followed up from 6 to 30 months. RESULTS: The effectiveness of ECT was 78% (25/32), and of ECT combined with PYM injection was 97% (35/36). The effectiveness of ECT combined with PYM injection was higher than that of ECT (P < 0.05). No serious adverse effects were encountered. CONCLUSIONS: ECT combined with PYM injection is an effective method for the treatment of high-return flow venous malformation.