Efficacy Of Tunable Dye Laser Therapy For The Treatment Of Infantile Hemangiomas
Brian Macias Martinez, BS1, Darisel N. Ventura Rodriguez, MS1, Marla C. Fortoul, BS1, Marissa Dallara, BS1, Eric J. Stelnicki, MD2, George Kamel, MD2.
1Nova Southeastern University, Fort Lauderdale, FL, USA, 2Atlantic Center of Aesthetic & Reconstructive Surgery, Fort Lauderdale, FL, USA.
PURPOSE: Infantile Hemangiomas (IH) are the most common tumor of childhood. Current treatment guidelines recommend oral propranolol, as the first line therapy for large IH. Tunable dye laser therapy (TDL) may offer an efficacious alternative without the risk of systemic complications. We aim to show the efficacy of laser treatment leading to the resolution without major complications.
METHODS: A retrospective cohort analysis of 100 patients with 138 IHs from 2016-2021 was performed. Patients were identified and divided into two groups: oral propranolol with TDL therapy (dual therapy) or TDL therapy only. Patient characteristics included: patients' age of onset and diagnoses, sex, associated syndromes, and history of prematurity. Clinical characteristics and treatment efficacy included size and number of hemangiomas, type of hemangioma, location, duration and number of treatments, and associated complications.
RESULTS: 100 patients met the inclusion criteria: 74 underwent TDL therapy and 26 underwent dual therapy. Cohorts were similar in age of onset and diagnoses, number of hemangiomas per patient, hemangioma size, type, location, sex, associated syndromes, and history of prematurity. Both treatment cohorts had similar involution rates, however patients in the dual therapy cohort experienced systemic side effects (n = 4 [15.4 percent] versus n = 0 [0 percent], p = .004). 80.8% of patients were successfully weaned off propranolol in the dual therapy group.
CONCLUSION: Both treatment cohorts had similar rates of involution in the treatment of large IH, however, dual therapy was associated with systemic side effects. TDL monotherapy serves as a safe and efficacious alternative.
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