Discussion: Oral prednisolone for infantile hemangioma: efficacy and safety using a standardized treatment protocol.

摘要

The debate over the use of corticosteroids or propranolol as first-line medical treatment for complicated infantile hemangiomas is perhaps the greatest controversy in the field of vascular anomalies today. Greene and Couto are to be commended for their excellent results with a standardized treatment protocol using prednisolone for treatment of difficult facial hemangiomas. However, corticosteroids are not without risks, particularly when used in infants. Steroids have been shown to have a significant adverse effect on B-and T-lymphocyte cell numbers and function after only 8 weeks of therapy, with decreased protective diphtheria and tetanus titers up to 3 months after discontinuation of treatment. The incidence of short-term complications such as cushingoid facies, personality changes, gastric irritation, and diminished growth is also not insignificant and cannot be dismissed as complications without justification.