Burn Hemangioma: Oral Propranolol is an Effective New Saving Therapy

Abstract

Background:  Burn hemangioma is new described variant of hemangioma that is commonly presented in winter time, that triggered by burning heat. It has many similarities to infantile hemangioma regarding the clinical course, histopathological picture. Its therapy is surgical resection. Objective:  To report new therapy for burn hemangioma by oral propranolol in large number of patients. Methods:  This is cross-sectional descriptive study with therapeutic trial where 14 cases of burn hemangioma were reported. Full demographic and clinical evaluation was performed. All patients were treated with oral propranolol in a dose of 1 mg/kg/day in 2 divided doses. In 3 (21.42%) cases of children, there was no improvement in 2 weeks after treatment, so the dose was increased to 2 mg/kg/day. Results:  A total of 14 cases were analyzed ,8(57.14%) females and 6 (42.85 %)males, their ages ranged from 6 months to 45 years. Two age groups were assessed: infants and children in 10(71.42%) cases with a mean age 5.75 years and 4(28.57%) in adults with a mean age 42.5 years. All patients had second degree burn apart from 2(14.28%) patients had combined 2nd and 3rd degree burn that followed contact with boiling liquids in 11(78.57%) cases, electric shock in 2(14.28%) cases and therapeutic cautery in one (7.14%) case. The hemangioma appeared after 1-2 weeks following burn injury. The therapeutic response was observed after few days but marked after 2 weeks but therapy continued for at maximum of six weeks until full resolution. No scarring was observed followed full resolution. Conclusion:  Burn hemangioma is commonly seen among children in winter cold months following burn with boiling liquid although occasionally can follow contact with any hot object like electric shock. Oral propranolol is a new an effective safe therapy leaving very good cosmetic appearance without scarring.