Местное лечение бетаблокаторами было прописано даже в последней взломанной версии Аптудейта, жаль, актуальная мне не доступна.
Из версии 21.2:
Цитата:
Topical beta blockers — Reports of successful treatment of hemangiomas with systemic propranolol led to the investigation of topical beta blocker therapy for the treatment of infantile hemangiomas [ 19,82 ]. (See 'Oral propranolol' above.)
Topical beta blockers may be used for the treatment of superficial hemangiomas of minor cosmetic concern as an alternative to topical corticosteroids (see 'Topical corticosteroids' above). Topical beta blockers also may have a role in preventing rebound growth in children who are being tapered off oral propranolol [ 83 ].
If a decision is made to use topical beta blockers, we use topical (ophthalmic) timolol 0.5 percent gel twice per day for 6 to 12 weeks or until stable improvement is achieved. If no response is seen after the first 4 to 6 weeks, treatment should be discontinued.
The efficacy of topical timolol has been confirmed in several case series [ 20,82,84-87 ]. In a multicenter retrospective study, 73 children (median age four months) were treated with topical timolol 0.5% gel twice daily for an average of three months [ 84 ]. In most cases, hemangiomas were superficial and localized to the head and neck. A mean improvement of 45 percent was observed in all but one patient. Favorable response was associated with superficial hemangiomas and treatment duration >3 months.
A few case series indicate that topical propranolol also may be beneficial for the treatment of superficial hemangiomas [ 88,89 ]. In one study, regression or cessation of growth was reported in 33 of 39 children aged ≤6 months after 2 to 16 months of therapy; improvement also was reported in all six children aged ≥7 months after 2 to 3 months of therapy [ 89 ]. In another study, a good or partial response was observed in 25 of 28 hemangiomas in 25 children after 5 to 59 weeks [ 88 ].
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