A 2-month-old infant presents to the pediatric clinic with a rapidly growing, bright red lesion on the cheek. The pediatrician diagnoses the lesion as a hemangioma. The parents are concerned about the lesion’s size and appearance, and they want to know the best treatment options available to manage the hemangioma effectively.
Which one of the following is considered the first line of therapy for the treatment of hemangioma?
A. Sclerosant Therapy
B. Embolization
C. Laser Ablation
D. None of them
Answer:
**The Correct Answer is: D. None of them
Explanation:
None of them (D):
– The first line of therapy for infantile hemangiomas, especially those that are growing rapidly or located in problematic areas (such as around the eyes, airways, or vital organs), is **oral propranolol**. Propranolol, a non-selective beta-blocker, has been found to be highly effective in reducing the size and growth of hemangiomas.
– Propranolol therapy has become the standard of care due to its efficacy and safety profile. It is usually started at a low dose and gradually increased under medical supervision.
Explanation of Incorrect Options:
Sclerosant Therapy (A):
– Sclerosant therapy involves injecting a sclerosing agent into the hemangioma to induce fibrosis and shrink the lesion. This treatment is not typically used as the first line for infantile hemangiomas but may be considered for specific cases, such as those that do not respond to other treatments or in older children and adults.
Embolization (B):
– Embolization is a procedure used to block the blood vessels supplying the hemangioma, causing it to shrink. It is generally reserved for large, complicated vascular lesions that are not responsive to other treatments. It is not the first line of therapy for typical infantile hemangiomas.
Laser Ablation (C):
– Laser ablation can be used to treat hemangiomas, particularly superficial lesions, or to manage residual skin changes after the hemangioma has been involuted. However, it is not considered the first line of therapy for the initial treatment of infantile hemangiomas.
In conclusion, the first line of therapy for the treatment of hemangioma is not included in the provided options, making “None of them” the correct answer. The standard treatment is oral propranolol.