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患儿女,3个月,出生后第10天右腹部发现4个针尖大小红色丘疹,体积逐渐增加至6mm×4mm×1.6mm(彩超测定皮损体积),色鲜红,皮肤镜下可见线团块分布的血管网。予以马来酸噻吗洛尔滴眼液局部湿敷(2次/d,每次1小时,每次约0.5m L),3个多月后瘤体仍扩大融合并隆起,皮肤镜下血管网簇集成团,边缘可见向外延伸的血管分支,提示仍有扩大趋势。更改治疗为伊曲康唑口服液内服[5mg/(kg·d)],治疗期间皮损颜色逐渐变暗,表面出现裂隙凹陷和皱纹,使之分成小叶状,皮肤镜下血管网变模糊,血管数量逐渐减少。治疗68天后(口服总量约2300 mg)临床及皮肤镜可观察到血管瘤有明显消退迹象遂停药随访。4月后血管瘤基本消退,残留少许纤维脂肪组织印迹。服药期间患儿肝肾功能在正常范围内,未见不适。伊曲康唑口服液治疗婴幼儿血管瘤服药方法简单方便,患儿及家属依从性好,治疗效果满意。皮肤镜在原位精准观察治疗过程血管瘤变化情况中起重要作用。
Children, 3 months, 10 days after birth found on the right abdomen 4 needle-shaped red papules, the volume gradually increased to 6mm × 4mm × 1.6mm (color measurement of lesion volume), bright red, visible under the microscope microscopic Block distribution of vascular network. To be timolol maleate eye drops local wet compress (2 times / d, each 1 hour, each about 0.5m L), more than 3 months after the tumor still expand fusion and uplift, dermo-microscopic vascular Cluster network cluster, the edge can be seen extending outward vascular branch, suggesting that there is still an expansion trend. Change the treatment of itraconazole oral administration of oral [5mg / (kg · d)], the skin lesions gradually darkened during treatment, the surface cracks and wrinkles, divided into lobular, dermoscopic vascular network become blurred, The number of blood vessels gradually decreased. 68 days after treatment (total oral dose of about 2300 mg) Clinical and dermoscopic hemangiomas were observed signs of regression was discontinued. After 4 months hemangioma subsided, leaving a small amount of fibrous adipose tissue imprinted. During the medication liver and kidney function in children within the normal range, no discomfort. Itraconazole oral solution for infantile hemangioma medication is simple and convenient, children and their families have good compliance, the treatment effect is satisfactory. Dermatoscopy in situ accurate observation of changes in the course of treatment of hemangiomas play an important role.