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Ulceration of infantile hemangiomas (IHs) can lead to pain, infection, bleeding, scarring, and feeding and sleeping difficulties. Data on treating ulcerated IH are few. Multimodal management, including local wound care, corticosteroids (systemic or intralesional), pulsed-dye laser, surgery, interferon-α, and vincristine, is based on clinical judgment. Healing can take up to several months. Since 2008, off-label use of propranolol for problematic IH has been increasing (see JW Dermatol Jun 20 2008). The authors of a recent report conducted a retrospective chart review including 33 infants to evaluate the response of ulcerated IH to propranolol.
All infants suffered pain; other complications included bleeding, feeding difficulties, and seconda…