Infantile Hämangiome im Lid- und Orbitabereich

I. Sterker; M. Weißer

doi:10.1055/s-0038-1660969

Kinder- und Jugendmedizin, Inhaltsverzeichnis

Kinder- und Jugendmedizin 2018; 18(03): 161-167
DOI: 10.1055/s-0038-1660969

Augenheilkunde

Schattauer GmbH

Infantile Hämangiome im Lid- und Orbitabereich

Infantile hemangiomas of the eyelids and the orbit

I. Sterker

¹Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig

,

M. Weißer

²Klinik für Kinderchirurgie, Universitätsklinikum Leipzig

› Institutsangaben

Abstract

Zusammenfassung

Infantile Hämangiome im Lid- und Orbitabereich können trotz ihres selbstlimitierenden natürlichen Verlaufs zu funktionellen Defiziten infolge einer Amblyopie oder Optikuskompression führen oder ein ästhetisch störendes Erscheinungsbild entwickeln und bedürfen dann einer Therapie.

Seit der „zufälligen” Entdeckung des Effektes von Propranolol auf infantile Hämangiome im Jahr 2008 wird diese Substanz zur Behandlung komplizierter Hämangiome eingesetzt, die ansonsten den Einsatz von Kortikosteroiden, Laser oder operativen Verfahren erfordert hätten. Propranolol systemisch ist derzeit bei komplizierten Hämangiomen der Lider und Orbita aufgrund des raschen und komplikationsarmen Therapieeffektes Therapie der ersten Wahl.

Dargestellt werden Pathogenese, Klassifikation, Indikation zur Therapie, Therapieoptionen sowie deren Effektivität für infantile Hämangiome im Lid- und Orbitabereich.

Weitere klinische Studien zur Optimierung von Dosierung, Behandlungsdauer und Art der Anwendung von Propranolol (lokal oder systemisch) sind jedoch weiterhin erforderlich, um den Regressionseffekt und die Regressionsrate weiter zu verbessern.

Summary

Despite the self-limiting natural course of infantile hemangiomas of the eyelids and orbit, effects of amblyopia, compression of the optic nerve, and impairment of the esthetic appearance may develop and in these cases therapy is necessary.

Since the serendipitous discovery of the effects of propranolol on infantile haemangioma in 2008, it has largely replaced the former standard treatments with corticosteroids, laser or surgical procedures. Propranolol is now the gold standard of therapy for complicated hemangiomas of the eyelids, and the orbit because of the prompt therapeutic effect and the less rate of complications.

This review discusses the pathogenesis, classification, indication of treatment, and treatment options and the treatment efficacy of propranolol for infantile hemangiomas of the eyelids and orbit.

Further clinical studies are necessary to optimize the dosage of propranolol, treatment period, and application modalities (oral or topical) and to improve the efficacy and rate of regression of hemangiomas.

Schlüsselwörter

Infantile Hämangiome - Lid- und Orbitabereich - Amblyopie - Propranolol

Keywords

Infantile hemangiomas - eyelids and orbit - amblyopia - propranolol

Volltext

Referenzen

Literatur
1 Munden A, Butschek R, Tom WL. et al. Prospective study of infantile hemangiomas. Br J Dermatol 2014; 170: 907-913.
2 Holland KE, Drolet BA. Infantile hemangioma. Pediatr Clin North Am 2010; 57: 1069-1083.
3 Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983; 18: 894-900.
4 Yap EY. et al. Periocular capillary hemangioma. Mayo Clin Proc 1998; 73: 753-759.
5 Goelz R, Poets CF. Incidence and treatment of infantile hemangioma in preterm infants. Arch Dis Child Fetal Neonatal Ed 2015; 100: F85-91.
6 Mulliken JB, Bischoff J, Kozakewich HPW. Multifocal rapidly involuting congenital hemangioma: a link to chorangioma. Am J Med Genet Part A 2007; 143A: 3038-3046.
7 Bauland CG, Lüning TH, Smit JM. et al. Untreated hemangiomas: growth pattern and residual lesions. Plast Reconstr Surg 2011; 127: 1643-1648.
8 Boon LM, Fishman SJ, Lund DP. et al. Congenital fibrosarcoma masquerading as congenital hemangioma: report of two cases. J Pediatr Surg 1995; 30: 1378-1381.
9 Boon LM, Enjolras O, Mulliken JB. et al. Congenital hemangioma: evidence of accelerated involution. J Pediatr 1996; 128: 329-335.
10 Mulliken JB, Bischoff J, Kozakewich HPW. Multifocal rapidly involuting congenital hemangioma: a link to chorangioma. Am J Med Genet Part A 2007; 143A: 3038-3046.
11 Haik GR, Jakobiak FA, Ellsworth RM. et al. Capillary hemangioma of the lids and orbit: an analysis of the clinical features and therapeutic results in 101 cases. Ophthalmology 1979; 80: 700-789.
12 Rootman J, Marotta TR, Graeb DA. Vascular lesions. In: Rootman J. (Hrsg). Diseases of the orbit, 2. Aufl. Philadelphia: Lippincott, Williams and Wilkins; 2003: 539-543.
13 Dinehart SM, Kincannon J, Geronemus R. Hemangiomas: evaluation and treatment. Dermatol Surg 2001; 27: 475-485.
14 Haggstrom AN, Lammer EJ, Schneider RA. et al. Patterns of infantile Hemangiomas: New Clues to Hemangioma pathogenesis and embryonic facial development. Pediatrics 2006a 117: 698-703.
15 Metry DW, Dowd CF, Barkovich AJ. et al. The many faces of PHACE syndrome. J Pediatr 2001; 139: 117-123.
16 Poetke M, Frommelt T, Berlien HP. PHACE syndrome: new views on diagnostic criteria. Eur J Pediatr Surg 2002; 12: 366-374.
17 Margileth AM, Museles M. Cutaneous hemangiomas in children: diagnosis and conservative management. JAMA 1965; 194: 523-526.
18 Interdisziplinäre Leitlinie “Infantile Hämangiome im Säuglings- und Kleinkleinkindesalter” (2015) der Deutschen Gesellschaft für Kinderchirurgie der Deutschen Gesellschaft für und Kinder- und Jugendmedizin der Deutschen Dermatologischen Gesellschaft der AG Pädiatrische Dermatologie und der Deutschen Gesellschaft für Mund-, Kieferund Gesichtschirurgie S2K-Leitlinie 006/100. www.AWMF-online-Leitlinien.de Abruf: 24.10.2017.
19 Millischer-Bellaiche AE, Enjolras O, Andre C. et al. Eyelid hemangiomas in infants: contribution of MRI. J Radiol 2004; 85: 2019-2028.
20 Robb RM. Refractive errors associated with hemangiomas of the eyelids and orbit in infancy. Am J Ophthalmol 1977; 83: 52-58.
21 Stigmar G, Crawford JS, Ward CM. et al. Ophthalmic sequelae of infantile hemangiomas of the eyelids and orbit. Am J Ophthalmol 1978; 85: 806-813.
22 Bogan S, Simon J, Krohel GB. et al. Astigmatism associated with adnexal masses in infancy. Arch Ophthalmol 1987; 105: 1368-1370.
23 Morrell AJ, Willshaw HE. Normalization of refractive error after steroid injection of adnexal hemangiomas. Br J Ophthalmol 1991; 75: 301-305.
24 Deady JP, Willshaw HE. Vascular hamartomas in childhood. Trans Ophthalmol Soc UK 1986; 105: 712-716.
25 Schwartz SR, Kodsi SR, Blei F. et al. Treatment of capillary hemangiomas causing refractive and occlusional amblyopia. J AAPOS 2007; 11: 577-583.
26 Léauté-Labrèze C, Harper JI, Hoeger PH. Infantile hemangioma. Lancet 2017; 390: 85-94 Doi: 10.1016/S0140-6736(16)00645-0. Epub 2017 Jan.
27 Höger PH. Hämangiome. Monatsschr Kinderheilkd 2011; 159: 1109-1118.
28 Drolet BA, Frommelt PC, Chamlin SL. Initiation and use of propranolol for infantile hemangioma: report of consensus conference. Pediatrics 2013; 131: 128-140.
29 Léauté-Labrèze C, Dumas de la Roque E, Hubiche T. et al. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008; 358: 2649-2651.
30 Marqueling AL, Oza V, Frieden IJ, Puttgen KB. Propranolol and infantile hemangiomaas four years later: a systematic review. Pediatr Dermatol 2013; 30: 182-191.
31 Léauté-Labrèze C, Hoeger PH, Mazereeuw-Hautier J. et al. A randomized controlled trial of oral propranolol in intantile hemangioma. N Engl J Med 2015; 372: 735-746.
32 Wedgeworth E, Glover M, Irvine AD. Propranolol in the treatment of infantile hemangiomas: lessons from the European Propranolol in the treatment of complicated hemangiomas (PITCH) Taskforce Survey. Br J Dermatol. 2015 published online Oct. 16. DOI:10.111/bjd.14233.
33 Reem RE, Golden RP. Periocular hemangiomas and lymphangiomas. Pediatr Clin North Am 2014; 61: 541-553.
34 Siegfried EC, Keenan WJ, Al-Jureidini S. More on propranolol for hemangiomas of infancy. N Engl J Med 2008; 359: 2846.
35 Chang L, Gu Y, Yu Z. When to stop propranolol for infantile hemangioma. Sci Rep. 2017 07. 43292 doi: 10.1038/srep4392 (2017).
36 Langley A, Pope B. Propranolol and central nervous system function: potential implications for pediatric patients with infantile hemangiomas. Br J Dermatol 2015; 172: 13-23.
37 Moyakine AV, Spillekom-van Koulil S, van der Vleuten CJM. Propranolol treatment of infantile hemangioma is not associated with psychological problems at 7 years of age. J Am Acad Dermatol 2016; 75: 59-63 e1. doi: 10.1016/j.jaad.2016.02.1218. Epub 2016 Mar 24.PMID: 27021240.
38 Bagazgoita L, Hernandez-Martin A, Torrelo A. Recurrence of infantile hemangiomas treated with propranolol. Pediatr Dermatol 2011; 28: 658-662.
39 Ahogo CK, Ezzedine K, Prey S. Factors associated with the relapse of infantile hemangiomas in children treated with oral propranolol. Br J Dermatol 2013; 169: 1252-1256.
40 Moehrle M, Léauté-Labrèze C, Schmidt V, Rocken M. et al. Topical timolol for small hemangiomas of infancy. Pediatr Dermatol 2013; 30: 245-249.
41 Pope E, Chakkittakandiyil A. Topical timolol gel for infantile hemangiomas: a pilot study. Arch Dermatol 2010; 146: 564-565.
42 Guo S, Ni N. Topical treatment for capillary hemangioma of the eyelid using beta-blocker solution. Arch Ophthalmol 2010; 128: 255-256.
43 Khanger N, Pahwa M. Dramatic response of a large hemifacial infantile hemangioma associated with PHACE syndrome to topical timolol lotion. Br J Ophthalmol 2011; 164: 886-888.
44 Chakkittakandiyil A, Phillips R, Frieden IJ. et al. Timolol maleate 0,5 or 0,1 % gel-forming solution for infantile hemangiomas: a retrospective, multicenter cohort study. Pediatr Dermatol 2012; 29: 28-31.
45 Chan H, McKay C, Adams S, Wargon O. RCT of timolol maleate Gel for superficial infantile hemangiomas in 5- to 24-weeks olds. Pediatrics 2013; 52: 281-286.
46 Bayart CB, Tamburro JE, Vidimos AT. Atenolol vs Propranolol for treatment of infantile hemangiomas during the proliferative phase: a retrospective noninferiority study. Pediatr Dermatol 2017; 34: 413-421.
47 Tasani M, Glover M, Martinez AE, Shaw L. Atenolol treatment for infantile hemangioma. Br J Dermatol 2017; 176: 1400-1402 doi: 10.1111/bjd.15317. Epub 2017 Mar 22. PMID: 28112790.