Infantile Haemangioma — SCE Dermatology MCQ
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Correct answer: C — Oral Propranolol (non-selective beta-blocker)
Oral Propranolol is the first-line systemic treatment for problematic infantile haemangiomas (IH) — those that are large, rapidly growing, causing functional impairment (visual axis obstruction, airway compromise, feeding difficulty), ulcerating, or disfiguring. The standard dose is 2-3 mg/kg/day divided TDS, started during the proliferative phase (typically before 6 months). Propranolol works through vasoconstriction, inhibition of angiogenesis (downregulating VEGF/FGF), and induction of endothelial cell apoptosis. Treatment is typically continued for 6-12 months. Pre-treatment cardiac assessment (heart rate, BP, ECG) is needed. Side effects include hypoglycaemia, bradycardia, bronchospasm, and sleep disturbance. Most uncomplicated IH can be observed (spontaneous involution occurs in 90% by age 4-5).
Reference: BAD 2019; NICE IPG; Paediatric Dermatology