Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort
Background: Functional impairment is the main consideration when it comes to choosing therapy for infantile hemangiomas (IH). However, since most hemangiomas are treated for cosmetic reasons, it is important to know the cosmetic outcome assessed by the parents. Objective: To evaluate the aesthetic o...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | Actas Dermo-Sifiliográficas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S000173102400601X |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849765555390644224 |
|---|---|
| author | M. Colmenero-Sendra J. del Boz-González E. Baselga Torres J. Bernabéu-Wittel E. Roé-Crespo A. Vicente M. Valdivieso-Ramos A. Martín-Santiago S.I. Palencia-Pérez M.T. Montserrat-García A. Azón-Masoliver M. Dañino C. Tubau Prims C. Prat A. Giacaman J.J. Domínguez-Cruz A. Bauzá Alonso M. Grau-Pérez M.Á. Descalzo I. García-Doval |
| author_facet | M. Colmenero-Sendra J. del Boz-González E. Baselga Torres J. Bernabéu-Wittel E. Roé-Crespo A. Vicente M. Valdivieso-Ramos A. Martín-Santiago S.I. Palencia-Pérez M.T. Montserrat-García A. Azón-Masoliver M. Dañino C. Tubau Prims C. Prat A. Giacaman J.J. Domínguez-Cruz A. Bauzá Alonso M. Grau-Pérez M.Á. Descalzo I. García-Doval |
| author_sort | M. Colmenero-Sendra |
| collection | DOAJ |
| description | Background: Functional impairment is the main consideration when it comes to choosing therapy for infantile hemangiomas (IH). However, since most hemangiomas are treated for cosmetic reasons, it is important to know the cosmetic outcome assessed by the parents. Objective: To evaluate the aesthetic outcomes of IH, considering the characteristics of the lesions and the treatments used. Patients and methods: The Spanish Infantile Hemangioma Nationwide Prospective Cohort (2016–2022) recruited all consecutive patients diagnosed with IH in 12 Spanish hospitals. The children included had two photos of the IH lesion (at both baseline and at the end of the study). A panel of parents blindly assessed all available photos using a scale from 0 (worst cosmetic outcomes) to 10 (best cosmetic outcomes). The different scores – both before and after treatment – as well as the outcomes percent considered excellent (>9) were described and compared. We analyzed the effect of receiving different therapies and performed causal model analyses estimating the mean treatment effect of parents’ assessments. Results: The median follow-up was 3.1 years. A total of 824 photos were evaluated. Baseline aesthetic impact was higher in the propranolol group vs the topical timolol and observation treatment groups (1.85 vs 3.14 vs 3.66 respectively; p < 0.001). After treatment, the aesthetic impact was similar between both treatment groups (7.59 vs 7.93 vs 7.90; p > 0.2). The causal model could only be applied to the comparison between topical timolol and observation, revealing no differences whatsoever. Conclusion: This is the first prospective cohort to analyze the aesthetic outcome of IH. The final aesthetic results of the three therapies were similar, with nearly 40% of patients achieving excellent aesthetic outcomes. Resumen: Antecedentes: El compromiso funcional es la principal indicación para iniciar tratamiento en los hemangiomas infantiles (HI). Sin embargo, muchos hemangiomas se tratan por el impacto estético que ocasiona en los niños, por lo que consideramos importante conocer el resultado cosmético evaluado por los padres. Objetivo: Evaluar el resultado estético de los HI, teniendo en cuenta las características de las lesiones y los tratamientos utilizados. Pacientes y métodos: La cohorte prospectiva española de HI (2016-2022) reclutó de manera consecutiva a todos los pacientes diagnosticados con HI en 12 hospitales españoles. A los niños incluidos se les realizaron dos fotografías de la lesión (una basal y otra al final del estudio). Un panel de padres realizó una evaluación ciega de todas las fotos utilizando una escala que iba de 0 (peor resultado cosmético) a 10 (mejor). Se describieron y compararon la diferencia de puntuación antes y después del tratamiento y el porcentaje de resultados considerados excelentes (>9). Se analizó el efecto de recibir diferentes terapias y se realizaron análisis de modelos causales estimando el efecto medio del tratamiento sobre las valoraciones de los padres. Resultados: La mediana de seguimiento fue de 3,1 años. Se evaluaron 824 fotografías. El impacto estético basal fue mayor en los grupos de tratamiento con propranolol que en los de timolol tópico y observación (1,85 vs 3,14 vs 3,66, respectivamente; p < 0,001). Después del tratamiento, el impacto estético fue similar entre los grupos de tratamiento (7,59 vs 7,93 vs 7,90; p > 0,2). El modelo causal solo pudo aplicarse a la comparación entre timolol tópico y observación, sin mostrar diferencias. Conclusiones: Presentamos la primera cohorte prospectiva que analiza el resultado estético de los HI. Los resultados estéticos finales de los tres tratamientos fueron similares, y alrededor del 40% de los pacientes describieron unos resultados estéticos excelentes. |
| format | Article |
| id | doaj-art-55707ea2e8af4a8983aa6e96a7000a92 |
| institution | DOAJ |
| issn | 0001-7310 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Actas Dermo-Sifiliográficas |
| spelling | doaj-art-55707ea2e8af4a8983aa6e96a7000a922025-08-20T03:04:48ZengElsevierActas Dermo-Sifiliográficas0001-73102025-04-01116432733610.1016/j.ad.2024.06.010Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective CohortM. Colmenero-Sendra0J. del Boz-González1E. Baselga Torres2J. Bernabéu-Wittel3E. Roé-Crespo4A. Vicente5M. Valdivieso-Ramos6A. Martín-Santiago7S.I. Palencia-Pérez8M.T. Montserrat-García9A. Azón-Masoliver10M. Dañino11C. Tubau Prims12C. Prat13A. Giacaman14J.J. Domínguez-Cruz15A. Bauzá Alonso16M. Grau-Pérez17M.Á. Descalzo18I. García-Doval19Dermatology Department, Hospital Costa del Sol, Marbella, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, SpainDermatology Department, Hospital Regional Universitario de Málaga, Spain; Corresponding author.Dermatology Department, Hospital Sant Joan de Déu, Universitat Autònoma de Barcelona, SpainDermatology Department, Hospital Virgen del Rocío, Sevilla, Spain; Dermatology Department, Hospital Viamed Santa Ángela de la Cruz, Sevilla, SpainDermatology Department, Hospital Santa Creu i Sant Pau, Barcelona, SpainDermatology Department, Hospital Sant Joan de Déu, Barcelona, SpainDermatology Department, Hospital Infanta Leonor, Madrid, SpainDermatology Department, Hospital Son Espases, Palma de Mallorca, SpainDermatology Department, Hospital 12 de Octubre, Madrid, SpainDermatology Department, Hospital Virgen del Rocío, Sevilla, Spain; Dermatology Department, Hospital Viamed Santa Ángela de la Cruz, Sevilla, SpainDermatology Department, Hospital Sant Joan de Reus, Tarragona, SpainDermatology Department, Hospital Virgen del Rocío, Sevilla, SpainDermatology Department, Hospital Santa Creu i Sant Pau, Barcelona, SpainDermatology Department, Hospital Sant Joan de Déu, Barcelona, SpainDermatology Department, Hospital Son Espases, Palma de Mallorca, SpainDermatology Department, Hospital Virgen del Rocío, Sevilla, Spain; Dermatology Department, Hospital Viamed Santa Ángela de la Cruz, Sevilla, SpainDermatology Department, Hospital Son Espases, Palma de Mallorca, SpainResearch Unit, Fundación Piel Sana AEDV, Madrid, Spain; Dermatology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, SpainResearch Unit, Fundación Piel Sana AEDV, Madrid, SpainResearch Unit, Fundación Piel Sana AEDV, Madrid, Spain; Dermatology Department, Complejo Hospitalario Universitario de Vigo, Vigo, SpainBackground: Functional impairment is the main consideration when it comes to choosing therapy for infantile hemangiomas (IH). However, since most hemangiomas are treated for cosmetic reasons, it is important to know the cosmetic outcome assessed by the parents. Objective: To evaluate the aesthetic outcomes of IH, considering the characteristics of the lesions and the treatments used. Patients and methods: The Spanish Infantile Hemangioma Nationwide Prospective Cohort (2016–2022) recruited all consecutive patients diagnosed with IH in 12 Spanish hospitals. The children included had two photos of the IH lesion (at both baseline and at the end of the study). A panel of parents blindly assessed all available photos using a scale from 0 (worst cosmetic outcomes) to 10 (best cosmetic outcomes). The different scores – both before and after treatment – as well as the outcomes percent considered excellent (>9) were described and compared. We analyzed the effect of receiving different therapies and performed causal model analyses estimating the mean treatment effect of parents’ assessments. Results: The median follow-up was 3.1 years. A total of 824 photos were evaluated. Baseline aesthetic impact was higher in the propranolol group vs the topical timolol and observation treatment groups (1.85 vs 3.14 vs 3.66 respectively; p < 0.001). After treatment, the aesthetic impact was similar between both treatment groups (7.59 vs 7.93 vs 7.90; p > 0.2). The causal model could only be applied to the comparison between topical timolol and observation, revealing no differences whatsoever. Conclusion: This is the first prospective cohort to analyze the aesthetic outcome of IH. The final aesthetic results of the three therapies were similar, with nearly 40% of patients achieving excellent aesthetic outcomes. Resumen: Antecedentes: El compromiso funcional es la principal indicación para iniciar tratamiento en los hemangiomas infantiles (HI). Sin embargo, muchos hemangiomas se tratan por el impacto estético que ocasiona en los niños, por lo que consideramos importante conocer el resultado cosmético evaluado por los padres. Objetivo: Evaluar el resultado estético de los HI, teniendo en cuenta las características de las lesiones y los tratamientos utilizados. Pacientes y métodos: La cohorte prospectiva española de HI (2016-2022) reclutó de manera consecutiva a todos los pacientes diagnosticados con HI en 12 hospitales españoles. A los niños incluidos se les realizaron dos fotografías de la lesión (una basal y otra al final del estudio). Un panel de padres realizó una evaluación ciega de todas las fotos utilizando una escala que iba de 0 (peor resultado cosmético) a 10 (mejor). Se describieron y compararon la diferencia de puntuación antes y después del tratamiento y el porcentaje de resultados considerados excelentes (>9). Se analizó el efecto de recibir diferentes terapias y se realizaron análisis de modelos causales estimando el efecto medio del tratamiento sobre las valoraciones de los padres. Resultados: La mediana de seguimiento fue de 3,1 años. Se evaluaron 824 fotografías. El impacto estético basal fue mayor en los grupos de tratamiento con propranolol que en los de timolol tópico y observación (1,85 vs 3,14 vs 3,66, respectivamente; p < 0,001). Después del tratamiento, el impacto estético fue similar entre los grupos de tratamiento (7,59 vs 7,93 vs 7,90; p > 0,2). El modelo causal solo pudo aplicarse a la comparación entre timolol tópico y observación, sin mostrar diferencias. Conclusiones: Presentamos la primera cohorte prospectiva que analiza el resultado estético de los HI. Los resultados estéticos finales de los tres tratamientos fueron similares, y alrededor del 40% de los pacientes describieron unos resultados estéticos excelentes.http://www.sciencedirect.com/science/article/pii/S000173102400601XHemangiomaPediatríaPropranololTimololEstudio prospectivoEstudios de cohortes |
| spellingShingle | M. Colmenero-Sendra J. del Boz-González E. Baselga Torres J. Bernabéu-Wittel E. Roé-Crespo A. Vicente M. Valdivieso-Ramos A. Martín-Santiago S.I. Palencia-Pérez M.T. Montserrat-García A. Azón-Masoliver M. Dañino C. Tubau Prims C. Prat A. Giacaman J.J. Domínguez-Cruz A. Bauzá Alonso M. Grau-Pérez M.Á. Descalzo I. García-Doval Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort Actas Dermo-Sifiliográficas Hemangioma Pediatría Propranolol Timolol Estudio prospectivo Estudios de cohortes |
| title | Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort |
| title_full | Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort |
| title_fullStr | Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort |
| title_full_unstemmed | Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort |
| title_short | Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort |
| title_sort | parental assessment of infantile hemangioma cosmetic clinical outcomes results of the spanish hemangioma nationwide prospective cohort |
| topic | Hemangioma Pediatría Propranolol Timolol Estudio prospectivo Estudios de cohortes |
| url | http://www.sciencedirect.com/science/article/pii/S000173102400601X |
| work_keys_str_mv | AT mcolmenerosendra parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT jdelbozgonzalez parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT ebaselgatorres parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT jbernabeuwittel parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT eroecrespo parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT avicente parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT mvaldiviesoramos parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT amartinsantiago parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT sipalenciaperez parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT mtmontserratgarcia parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT aazonmasoliver parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT mdanino parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT ctubauprims parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT cprat parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT agiacaman parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT jjdominguezcruz parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT abauzaalonso parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT mgrauperez parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT madescalzo parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort AT igarciadoval parentalassessmentofinfantilehemangiomacosmeticclinicaloutcomesresultsofthespanishhemangiomanationwideprospectivecohort |