Response of Ulcerated Perineal Hemangiomas of Infancy to Becaplermin Gel, a Recombinant Human Platelet-Derived Growth Factor

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Abstract
Background Hemangiomas of infancy are the most common tumors of childhood , and ulceration is the most common complication. Many treatments have been usedfor hemangioma ulceration, although none are uniformly effective. A recent report described the successful use of 0.01% becaplermin gel, a recombinanthuman platelet-derived growth factor, for an ulcerated hemangioma refractory to standard care. We sought to further assess the responsiveness of hemangiomaulceration to 0.01% becaplermin gel and to compare its cost to that of conventional modalities. Observations We report a case series of 8 infants treated with becaplermin gel for ulcerated perineal hemangiomas of infancy. All infants were seen between Januaryand June 2003 in the pediatric dermatology clinic at Texas Children's Hospital.Six female and 2 male infants were included. All of the hemangiomas were large(≥6 cm2), and of superficial or mixed superficial and deep morphology. Rapid ulcer healing occurred in all patients within 3 to 21 days (average,10.25 days). Conclusions In this small series, 0.01% becaplermin gel was a safe and effective treatment for perineal hemangioma ulceration. The rapid healing achieved with0.01% becaplermin gel allows a reduction in the risk of secondary infection, pain, and need for hospitalization, as well as in the costs that often accumulatefrom multiple follow-up visits and long-term therapy.