Treatment of infantile hemangioma with topical imiquimod 5% cream

Background: Infantile hemangioma is a congenital vascular malformation. Although almost all cases are self-limiting, treatment is sometimes necessary. According to previous studies, topical imiquimod induces resolution of lesions with an acceptable safety profile. The aim of the present study was to evaluate the effect of this topical treatment on Iranian infantile hemangioma patients. Method: Patients under two years of age with infantile hemangioma who were not candidates for immediate systemic therapy with steroids were selected if the lesions were not ulcerated. Topical 5% imiquimod was applied on the lesions for 16 weeks. All the lesions were photographed before the commencement of the study and at the end of the treatment. Photographs were compared by two associate dermatology professors to evaluate the effect of treatment using a visual analogue scale. Result: A total of 15 patients including five males (33.3%) and ten females (66.7%), with an age range of two to 18 months and a mean age of 9.1 (± 6.3) months, were enrolled in the study. The mean diameter of the lesions was 2.6 cm (± 1.8 cm). Nine patients (60%) had moderate response and five patients (33.3%) had good response while one patient had excellent response. Complications were mild local irritation and pruritus. Conclusion: It seems that topical imiquimod could be a suitable option in the treatment of some infantile hemangioma lesions not candidate for systemic treatment and/or other local measures such as laser and intra lesional steroid or when other drugs are useless or harmful.