There are two clearly differentiated attitudes in the
treatment of haemangiomas: the expectant attitude and
the therapeutic, medical or surgical attitude. The expectant
attitude can be appropriate in cases of small haemangiomas,
far from areas of possible functional damage,
and with a slow rate of growth; however, it must be
remembered that after reaching their maximum involution,
about 25% of haemangiomas show a significant
deformity. Treatment should be applied to those haemangiomas
that obstruct the visual axis, the airway, the
auditory channel, (with alteration of functions such as
vision, breathing, swallowing and urinary or intestinal
functions); to those of rapid growth that produce or
might produce tissue destruction or significant disfiguration,
ulcerated lesions, and lesions with a great cutaneous
extension or visceral affection, which can lead to
congestive cardiac insufficiency, or haematological
alterations. The recommended treatment is systemic
corticosteroids, with an initial dose of 2 to 3 mg/kg/day
of prednisone or prednisolone, administered once a day
in the morning. The most frequent result is that growth
is arrested, while a reduction in size is observed in less
than half the cases. Intralesional administration of corticosteroids
at intervals of between 4 and 8 weeks is an
effective treatment that manages to avoid the adverse
effects of systemic corticosteroids. Because of its
adverse neurological effects, interferon is only recommended
for lesions with a vital or severe functional risk
that do not respond to corticosteroids. Cytotoxic drugs
are another treatment group: intralesional bleomycin,
vincristine, cyclophosphamide and pingiangmycin
