Topical timolol maleate combined with oral propranolol in treatment for nasus externus infantile hemangiomas: a retrospective study of 17 cases

The aim of our study was to assess the efficacy and safety of topical timolol maleate combined with oral propranolol for nasus externus infantile hemangiomas. Between March 2012 and May 2014, propranolol was given orally to 17 infants with proliferating hemangiomas in a dose of 1.0-1.5 mg/kg/day in our department and dipped topically a small amount of 0.5% timolol maleate eye drops with medical cotton swabs on hemangiomas lesion area of the children twice a day by every 12 hours. There were 6 males and 11 females aged from 2 months to 11 months with a median of 5.4 months. The lesions were located in the nasus externus region, and measured 0.5 cm × 0.5 cm-2.5 cm × 2 cm in volume. The therapy duration was planned for 6-8 months or the two drugs were stopped when complete regression of lesions was obtained. The therapeutic outcomes and safety were assessed by the changes of color, size of tumor, and adverse effects throughout the course of treatment. The mean therapy duration was 22.8 weeks ranged from 3 to 8 months. Of 17 the patients, 13 demonstrated excellent response, 3 showed good response, and 1 displayed moderate response. No major collateral effects were observed. Oral propranolol combined with topical timolol maleate might be used as the first-line treatment selection in the treatment of nasus externus infantile hemangioma.