Good Clinical Responders to Topical Timolol in Patients with Infantile Hemangiomas: A 7-Year Retrospective Study of 328 Korean Patients

다국어 초록 (Multilingual Abstract)

Background: Topical timolol is widely used for treatment of superficial infantile hemangioma(IH). However, little is known about factors that affect the response to topical timololtreatment.
Objective: This study aimed to investigate the efficacy, safety, and predictive value for goodresponse to topical timolol for IH.
Methods: A retrospective review of medical records and clinical photos of 328 patientswith IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographswere compared with those at the initial visit using a 100-mm visual analogue scale(VAS). Treatment response was defined as an improvement of at least 75% from baselinein IH lesions within 12 months of treatment.
Results: Overall, IH patients treated with topical timolol showed significant improvementfrom baseline, showing that the final VAS score within 12 months of treatment was69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment(p=0.007), length of gestation and fetal growth (p=0.03), depth (p=0.01), and flexuralarea (p=0.007) were significantly associated with treatment response. Only four patients(1.1%) reported local irritation.
Conclusion: This study demonstrated that topical timolol treatment was an effective andwell-tolerated treatment for IHs. Physicians are encouraged to consider several patient- orlesional factors that might affect treatment response to achieve better clinical outcomes.

참고문헌 (Reference)

1 이현지 ; 하기웅 ; 정호윤 ; 이종민 ; 이상엽 ; 허승 ; 김지윤 ; 이석종, "유아혈관종 환아 375명에서 두 가지 제형의 경구 프로프라놀롤 치료 효과와 안전성에 대한 한국 단일기관에서의 경험" 대한피부과학회 59 (59): 196-205, 2021

2 오재홍 ; 김병윤 ; 최미라, "신생아 집중치료실 환아에서 유아혈관종의 위험인자 분석" 대한피부과학회 59 (59): 332-340, 2021

3 Wu HW, "Topical timolol vs. oral propranolol for the treatment of superficial infantile hemangiomas" 8 : 605-, 2018

4 Püttgen K, "Topical timolol maleate treatment of infantile hemangiomas" 138 : e20160355-, 2016

5 Xu DP, "Topical timolol maleate for superficial infantile hemangiomas : an observational study" 73 : 1089-1094, 2015

6 Danarti R, "Topical timolol maleate 0. 5% for infantile hemangioma : its effectiveness compared to ultrapotent topical corticosteroids-a single-center experience of 278 cases" 232 : 566-571, 2016

7 Weibel L, "Topical timolol for infantile hemangiomas : evidence for efficacy and degree of systemic absorption" 33 : 184-190, 2016

8 Wu HW, "Topical application of 0. 5% timolol maleate hydrogel for the treatment of superficial infantile hemangioma" 7 : 137-, 2017

9 박영운 ; 염꽃보라 ; 김규한, "Timolol 국소 도포로 치료한 궤양성 영아 혈관종" 대한피부과학회 50 (50): 880-883, 2012

10 Khan M, "The role of topical timolol in the treatment of infantile hemangiomas : a systematic review and meta-analysis" 97 : 1167-1171, 2017

11 Wang X, "The efficacy and safety of topical β-blockers in treating infantile hemangiomas : a metaanalysis including 11 randomized controlled trials" 237 : 433-443, 2021

12 van Gils RF, "The effectiveness of integrated care for patients with hand eczema : results of a randomized, controlled trial" 66 : 197-204, 2012

13 He L, "Spectral Doppler ultrasound for predicting longterm response to topical timolol in children with infantile hemangioma" 45 : 480-487, 2017

14 Nedelec B, "Skin characteristics : normative data for elasticity, erythema, melanin, and thickness at 16 different anatomical locations" 22 : 263-275, 2016

15 Borok J, "Safety and efficacy of topical timolol treatment of infantile haemangioma : a prospective trial" 178 : 51-52, 2018

16 Ding Y, "Risk factors for infantile hemangioma : a meta-analysis" 16 : 377-384, 2020

17 Chan H, "RCT of timolol maleate gel for superficial infantile hemangiomas in 5-to 24-week-olds" 131 : e1739-, 2013

18 Munden A, "Prospective study of infantile haemangiomas : incidence, clinical characteristics and association with placental anomalies" 170 : 907-913, 2014

19 Martin K, "Propranolol treatment of infantile hemangiomas : anticipatory guidance for parents and caretakers" 30 : 155-159, 2013

20 Moyakine AV, "Propranolol treatment of infantile hemangioma(IH)is not associated with developmental risk or growth impairment at age 4years" 75 : 59-63, 2016

21 Wedgeworth E, "Propranolol in the treatment of infantile haemangiomas : lessons from the European Propranolol In the Treatment of Complicated Haemangiomas(PITCH)Taskforce survey" 174 : 594-601, 2016

22 Léauté-Labrèze C, "Propranolol for severe hemangiomas of infancy" 358 : 2649-2651, 2008

23 Marqueling AL, "Propranolol and infantile hemangiomas four years later : a systematic review" 30 : 182-191, 2013

24 Langley A, "Propranolol and central nervous system function : potential implications for paediatric patients with infantile haemangiomas" 172 : 13-23, 2015

25 Wang Y, "Mental health status of cisgender and gender-diverse secondary school students in China" 3 : e2022796-, 2020

26 Kilcline C, "Infantile hemangiomas: how common are they? A systematic review of the medical literature" 25 : 168-173, 2008

27 Drolet BA, "Infantile hemangiomas : an emerging health issue linked to an increased rate of low birth weight infants" 153 : 712-715, 2008

28 Leung AKC, "Infantile hemangioma : an updated review" 17 : 55-69, 2021

29 Léauté-Labrèze C, "Infantile haemangioma" 390 : 85-94, 2017

30 김도엽 ; 박현선 ; 조소연 ; 윤현선, "Factors Determining Treatment Response to Cryotherapy for Foot Warts" 대한피부과학회 31 (31): 457-460, 2019

31 Qiao J, "Efficacy of combined topical timolol and oral propranolol for treating infantile hemangioma : a meta-analysis of randomized controlled trials" 11 : 554847-, 2020

32 Muñoz-Garza FZ, "Efficacy and safety of topical timolol for the treatment of infantile hemangioma in the early proliferative stage : a randomized clinical trial" 157 : 583-587, 2021

33 Zheng L, "Effect of topical timolol on response rate and adverse events in infantile hemangioma : a meta-analysis" 310 : 261-269, 2018

34 Park YW, "Effect of propranolol on the treatment of infantile hemangiomas : a single tertiary center 3-year experience" 25 : 391-395, 2014

35 Chansky PB, "Cutaneous dermatomyositis disease course followed over time using the Cutaneous Dermatomyositis Disease Area and Severity Index" 79 : 464-469, 2018

36 Vossen ARJV, "Apremilast for moderate hidradenitis suppurativa : results of a randomized controlled trial" 80 : 80-88, 2019

37 Léauté-Labrèze C, "A randomized, controlled trial of oral propranolol in infantile hemangioma" 372 : 735-746, 2015

38 김병욱 ; 문익준 ; 윤우진 ; 정보영 ; 김상덕 ; 이가영 ; 장성은, "A Randomized, Evaluator-Blinded, Split-Face Comparison Study of the Efficacy and Safety of a Novel Mannitol Containing Monophasic Hyaluronic Acid Dermal Filler for the Treatment of Moderate to Severe Nasolabial Folds" 대한피부과학회 28 (28): 297-303, 2016