Comparative study between oral and intralesional injection of beta-blocker in the treatment of infantile capillary hemangioma

Abstract Purpose The present is conducted with the aim of comparing the clinical efficacy and side effects of oral versus intralesional propranolol treatment of infantile capillary hemangiomas. Methods Study enrolled 40 infants diagnosed with infantile capillary hemangiomas. Patients were divided into two groups: Group A (non-invasive group) included 20 infants who received oral propranolol hydrochloride starting with the 1 mg/kg/day BID dose, then rose to a max of 2 mg/kg/day BID gradually over 2 weeks for three months. Group B (invasive group) included 20 infants, who received intralesional propranolol injection at a dose of 1 mg/mL. The size of the lesion served as the factor that determined the volume of drug injection (0.2 mL injection/cm of the diameter of the lesion), considering the use of 1 mL for a 5-cm diameter lesion as a maximum case under complete aseptic conditions in the operating theater. Results At 3 months after initiating treatment, the circumferential size of the hemangioma showed a statistically significant decrease in both groups; in group A from 3.66 ± 2.89 cm to 1.56 ± 1.26 cm with P -value < 0.05 and in group B from 2.99 ± 2.73 cm to 1.32 ± 1.18 cm with P -value < 0.05. There is no statistically significant comparative difference between the two groups ( P -value = 0.538 = insignificant). Regarding the complications of oral propranolol, one patient(5%) had bradycardia, and one patient (5%) had diarrhea. In the injection group, 20 patients (100%) had local edema, and 1 patient (5%) experienced local infection. Conclusions Both oral non-invasive and intralesional invasive propranolol are safely and equally statistically successfully effective in the treatment of infantile hemangioma, showing reduction of the size of the hemangioma with no statistical comparative difference between both treatment techniques.