Combination therapy of oral propranolol and combined Nd:YAG/pulsed dye laser therapy in infantile hemangiomas: a retrospective analysis of 48 treated hemangiomas in 30 children

Summary Background and aims Infantile hemangiomas can be successfully treated by both systemic propranolol and neodymium:YAG (Nd:YAG)‐dye laser combination therapy. In this retrospective study, the efficacy and safety of sequential and parallel therapy of complicated hemangiomas treated with both methods were evaluated. Patients and methods 30 children with 48 complicated hemangiomas were treated with propranolol and Nd:YAG‐dye laser combination therapy. Using photo comparison, the percentage remission rate was evaluated by three investigators on a four‐step scale (I: 0–25 %, II: 26–50 %, III: 51–75 % and IV: 76–100 %). Results Eleven children received propranolol and laser therapy in parallel (A), twelve children received laser therapy after propranolol (B) and seven children received propranolol after laser therapy (C). Due to emigration abroad, one child was lost to follow‐up. A strong improvement (IV) was observed in 23/29 (79.3 %) of all treated children (A: 90.9 %, B 75 %, C 66.7 %). The mean duration of propranolol therapy in all children was 8.6 months (A: 8.9 months, B: 8.2 months, C: 8.9 months). On average, 2.33 laser treatments were performed per hemangioma (A: 1.95, B: 3.2, C: 1.91). Serious side effects caused by propranolol and laser therapy were not observed. Conclusions Propranolol and Nd:YAG‐dye laser combination therapy can be used sequentially or in parallel safely and effectively. They complement each other in a meaningful manner.