Rebound of hemangioma after withdrawal of oral propranolol.

Abstract

Soon after the discovery of the effectiveness of propranolol in the treatment of infantile hemangioma (4) we became aware of the differences compared to old corticosteroid treatment: greater efficiency, minor but different side effects, especially higher incidence of the phenomenon of rebound (1, 3). The latter, also observed with topical administration of propranolol (2), does not occur immediately after the suspension of the drug, but usually at a distance of weeks or months. To overcome the rebound, we increased the dose of propranolol adapting it to the increase in weight of the child, we prolonged the period of administration, we started to administer it as early as possible, we sometimes associated corticosteroids to propranolol. All of these efforts have reduced but not eliminated the rebound phenomenon.