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Oral Hemangiomas Medication

  • Author: Steven Brett Sloan, MD; Chief Editor: William D James, MD  more...
 
Updated: Feb 09, 2016
 

Medication Summary

No medications, other than those used for initial treatment, are needed. For patients with an asymptomatic oral vascular malformation that is stable, nonprogressive, and that has no functional impairment or bleeding, observation is indicated. Painful perioral hemangiomas may manifest as difficult feeding and failure to thrive. Topical lidocaine-containing preparations, acetaminophen, and codeine have all been used for pain control. Smidt and Strand reported a painful hemangioma controlled with over-the-counter Orabase. Orabase contains 20% benzocaine, and possible adverse effects include allergic contact dermatitis and methemoglobinemia.[63]

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Corticosteroids

Class Summary

Steroids have become a mainstay in the treatment of proliferating hemangiomas in infants and children. These agents have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.

Prednisone (Meticorten, Orasone, Deltasone, Sterapred)

 

Prednisone is an immunosuppressant for the treatment of autoimmune disorders; it may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Prednisone stabilizes lysosomal membranes and suppresses lymphocyte and antibody production.

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Interferons

Class Summary

These agents are naturally produced proteins with antiviral, antitumor, and immunomodulatory actions. Alpha, beta, and gamma interferons may be given topically, systemically, and intralesionally.

Interferon alfa-2b (Intron-A)

 

Interferon alfa-2b is a protein product manufactured by recombinant DNA technology. Its mechanism of antitumor activity is not clearly understood; however, direct antiproliferative effects against malignant cells and modulation of host immune response may play important roles.

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Antihypertensive Agent

Propranolol

 

Propranolol hydrochloride is a synthetic nonselective beta-adrenergic receptor blocking agent. A generic form is available as 10-, 20-, 40-, 60-, and 80-mg tablets and as 60-, 80-, 120-, and 180-mg extended-release tablets. Inderal is available as 10-, 20-, 40-, 60-, and 80-mg tablets for oral administration. InnoPran XL is available as 80- and 120-mg extended-release tablets. No commercially available liquid formulation is available for use in children and must be formulated by a qualified pharmacist. It is indicated for hypertension and a variety of other cardiac conditions (angina) and migraine headache prophylaxis.

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Anesthetics, Oropharyngeal

Benzocaine

 

Benzocaine is a PABA derivative ester-type local anesthetic that is minimally absorbed. It inhibits neuronal membrane depolarization, blocking nerve impulses. It is used to control pain.

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Contributor Information and Disclosures
Author

Steven Brett Sloan, MD Associate Professor, Department of Dermatology, University of Connecticut School of Medicine; Residency Site Director, Connecticut Veterans Affairs Healthcare System; Assistant Clinical Professor, Yale University School of Medicine

Steven Brett Sloan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Connecticut State Medical Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Journal of the American Academy of Dermatology;Up to Date;Medical Review Institute of America.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Neil Shear, MD Professor and Chief of Dermatology, Professor of Medicine, Pediatrics and Pharmacology, University of Toronto Faculty of Medicine; Head of Dermatology, Sunnybrook Women's College Health Sciences Center and Women's College Hospital, Canada

Neil Shear, MD is a member of the following medical societies: Canadian Medical Association, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada, Canadian Dermatology Association, American Academy of Dermatology, American Society for Clinical Pharmacology and Therapeutics

Disclosure: Nothing to disclose.

Acknowledgements

Randall Wilk, MD, DDS, PhD Associate Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Science Center

Randall Wilk, MD, DDS, PhD is a member of the following medical societies: American Association of Oral and Maxillofacial Surgeons, American Dental Association, and American Medical Association

Disclosure: Nothing to disclose.

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Table 1. Classification of Vasoformative Tumors
Vasoformative Tumor New Nomenclature Old Nomenclature
Hemangiomas  
 Capillary hemangiomaStrawberry hemangioma
  Juvenile hemangioma
 Cavernous hemangioma 
 Mixed hemangiomaParotid hemangioma
Vascular malformations  
 Venous malformationCavernous hemangioma
  Hemangiomatosis
 Intramuscular venous malformationIntramuscular hemangioma
 Capillary malformationCapillary hemangioma
  Port-wine stain
 Arteriovenous malformationArteriovenous hemangioma



Arterial angioma



Arteriovenous aneurysm



Cirsoid angioma



Red angioma



Serpentine aneurysm



 Lymphatic malformationCapillary lymphangioma



Cavernous lymphangioma



Lymphangioma



Cystic hygroma



Table 2. Complications From Ablative Surgery Following Embolotherapy or Sclerotherapy for Hemangiomas and Vascular Malformations
Complications Hemangiomas, % Vascular Malformations, %
Immediate Complications
Hemorrhage2760
Airway compromise210
Hematoma1414-30
Skin necrosis1210-30
Coagulopathy714-20
Late Complications
Restricted oral opening827-40
Malocclusion820-40
Drooling2340-47
Dysphagia2320-27
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