Keywords : bleomycin injection

The Role of Intralesional Bleomycin in the Management of Cutaneous Infantile Hemangioma

Iraqi Postgraduate Medical Journal, 2018, Volume 17, Issue 3, Pages 204-210

Infantile hemangioma, although often small after birth, it tends to follow a proliferative phase in which the growth may be rapid and unpredictable. Besides, its involution often takes many years to happen causing psychological problems and embarrassment to the parents as well as their child.
To evaluate the efficacy of intralesional bleomycin in the management of infantile cutaneous hemangiomas and to assess the possible side effects and complications of this treatment modality.
A prospective study done in Iraq over the period from October 2014 to December 2015, were 28 patients with cutaneous infantile hemangiomas had been treated by intralesional bleomycin injection, 0.25-0.5 unit/kg/dose, administered subcutaneously. The enrolled patients were divided depending on lesion size at time of presentation into two groups; those with hemangiomas less than 12 cm2 and others with lesions greater than 12 cm2. The lesions were measured serially and monitored with photos for follow up and documentation. Side effects were also recorded. Lesion’s response was graded into five grades according to the final size after treatment.
The mean age of the studied patients was 13.5±11.2 months (3 months to 4 years). The mean number of injections given was 3.7±0.7(3 to 5), and the mean total dose administered was 3.8±1.5 units/patient(2.5 to 9). Complete involution (>90% reduction in the size of the hemangioma) was recorded in 9(32.1%) children. Twelve (42.9%) children were reported to achieve 75-90% reduction in the size of the hemangioma. In 6(21.4%) children, there was a 50-75% reduction in the size of the lesion, and only 1 patient had <25% reduction in the size of the lesion. The mean follow up period was 5.8±2.1 months (3 to 10 months).Hyperpigmentation was the most common complication and was reported in 11(42.3%)patients.
Intralesional bleomycin is an effective option in the treatment of cutaneous infantile hemangioma