The potential role of progesterone during pregnancy as an induction of infantile hemangioma

Infantile hemangioma (IH) is one of the most common benign tumors in infants characterized by occurrence within a few weeks after birth,rapid growth during the first year and spontaneous involution over a period of several years.Despite the high incidence rate of 5％-10％ in infants of mixed European descent,detailed pathogenesis of IH remains elusive.Recent studies have indicated multipotential stem cells derived from hemangioma tissue (HemSCs) could recapitulate human infantile hemangioma in immunodeficient mice.Considering the effect of progesterone on regulation of cytokines and growth factors in endometrium as well as the inhibition of immune response,using progesterone during pregnancy might help the HemSCs escape from the immune response and reside in the tissue of embryo by the aid of increased MMPs and decreased TIMPs,then proliferation was stimulated by increased growth factors like VEGF and bFGF.Thus,IH is potentially produced.Supported by National Natural Science Foundation of China (81070846).

The clinical significance of bimodal growth pattern in the treatment of hemangiomas in infancy and children

Hemangiomas are the most common benign vascular neoplasms of infancy and children, the life cycle of which involves a phase of rapid proliferation in the neonatal period, followed by spontaneous involution, usually during childhood [1].

Background: Systemic treatment with propranolol is proven to be effective for patients with hemangiomas with less side-effect. We used a propranolol gel for topical use on hemangiomas.
Methods: In this retrospective study, we analyzed 148 patients who had been treated topically with propranolol gel for 12 weeks. We analyzed the data of patients and clinically gave each hemangioma a "hemangioma score" to determine the treatment success.
Results: In 147 of the 148 patients, strong signs of resolution under treatment included lightening, paling, and less vascularization. The hemangioma score showed a signifi cant decrease during the treatment. Relevant serum levels of propranolol were not found. Adverse effects were rare and not related to propranolol.
Conclusion: Topical treatment with propranolol gel is suitable for specific hemangiomas in addition to cryotherapy and systemic treatment with propranolol.