The Efficacy of Timolol 0.5% Gel Forming Solution for the Treatment of Ulcerated Hemangiomas
Ulceration is the most common complication associated with infantile hemangiomas. Ulceration
and the delay in wound healing places patients at risk for infection, bleeding, pain and
permanent scarring. Currently, the care of ulcerated hemangiomas is extremely difficult and
patients are often subject to multiple treatment modalities.
In the past two years, the leading advance in the treatment of hemangiomas has been the use
of the non-selective, oral beta-blocker propranolol to arrest growth and promote involution
of hemangiomas. Recent literature also suggests beta-blockers may have a role in helping
ulcerated wounds re-epithelialize.
The use of a topical non-selective beta-blocker on isolated ulcerated hemangiomas may
promote early healing and reduce the number of complications associated with ulceration.
Investigation is needed to explore the safety and tolerability of applying a topical
beta-blocker on an ulcerated hemangioma and whether topical beta-blockade may be more
efficacious than conservative care with topical antibiotics.
In this study, infants will be randomized to either receive a topical antibiotic (topical
mupirocin 2% ointment twice per day) or a topical beta-blocker (Timolol 0.5% Gel Forming
Solution) according to a dose-escalation schedule. Subjects will be seen in clinic on day 7,
day 14, 1 month and 2 months into therapy and 1 month after therapy is completed.
Photographs and safety and efficacy measurements will be taken at each visit to assess
response to therapy.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Time to Wound Re-epithelization
At 3 months
Albert C. Yan, MD
Children's Hospital of Philadelphia, Chair of Pediatric Dermatology
United States: Institutional Review Board
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