An inSPECTion: Is Propranolol Safe in PHACES Syndrome?

Since 2008, propranolol has been increasingly used to treat infantile hemangiomas (JW Dermatol Jun 20 2008). Facial hemangioma is part of the constellation of congenital anomalies that make up PHACES syndrome (Posterior fossa malformations, facial Hemangioma, Arterial anomalies, Cardiac anomalies, Eye anomalies, and Sternal/ventral defects). Because cerebrovascular malformations, the main risk factor for stroke in healthy children, are associated with PHACES syndrome, propranolol has been considered relatively or absolutely contraindicated in these children. However, propranolol is used as antihypertensive medication in children with a history of stroke, and its safe use in PHACES patients has been reported. Investigators in Spain evaluated…