Abstract: Ye Wenxia, Jin Wanwan, Quan Hehe, Fang Shan, Xue Ximao, Tong Yi, Lu Shujiao, Gao Yu Department of Dermatology, The 2nd Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University, Wenzhou 325000, China （the current affiliation of the first author was Department of Dermatology, Lishui City People′s Hospital, Lishui 323000, Zhejiang, China） Corresponding authors: Gao Yu, Email: gaoyu0570@163.com; Lu Shujiao, Email: lslsj120 @163.com 【Abstract】 Objective To evaluate the clinical efficacy and safety of 595-nm pulsed dye laser with topical timolol maleate 0.5% solution for the treatment of superficial infantile hemangioma （IH）. Methods Complete clinical data were collected from 156 infants with superficial IH, who received treatment with 595-nm pulsed dye laser combined with topical timolol maleate 0.5% solution in the Department of Dermatology of the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from July 2015 to July 2016, and analyzed retrospectively. Of the 156 patients, 44 were males, and 112 were females, with an average age of 3.8 ± 0.7 months （range, 24 days - 1 year）. These patients were treated with 595-nm pulsed dye laser every 5 weeks and topical application of timolol maleate solution twice a day. Each treatment with timolol maleate solution lasted 30 minutes. When the hemangioma regressed generally, the treatment with laser and timolol maleate solution was stopped. At weeks 5, 10, 15 and 30, the visual analogue scale （VAS） was used to evaluate the efficacy, and adverse reactions were recorded. These patients were followed up till 6 months after the end of treatment. The relationships of area and thickness of hemangioma with treatment duration, treatment sessions and VAS scores were analyzed. Results After 5 - 30 weeks of treatment, hemangiomas regressed to different extents, and the cure rate was 93.59% （146/156）. At weeks 5, 10, 15 and 30, the VAS scores were 3.12 ± 0.23, 4.45 ± 0.52, 5.45 ± 0.71 and 7.59 ± 1.64 respectively. Repeated-measures analysis of variance showed that the VAS scores all significantly increased over time （F = 189.35, P < 0.05） in the 3 groups with different initial thickness of hemangiomas （< 1 mm, 1 - 3 mm, and > 3 mm）, and significantly differed among the above 3 groups at different time points （F = 215.56, P < 0.05）, and the group with the initial thickness of hemangiomas < 1 mm showed the highest VAS scores. The total treatment duration was significantly shorter in the group with the initial thickness of hemangiomas < 1 mm （2.71 ± 0.58 months） than in those with the initial thickness of hemangiomas 1 - 3 mm （8.22 ± 0.67 months, P < 0.05） and > 3 mm （11.03 ± 0.72 months, P < 0.05）. The VAS scores also significantly differed among the 3 groups with different initial area of hemangiomas （< 3 cm2， 3 - 9 cm2 and > 9 cm2）, and significantly increased over time in these groups; Kruskal-Wallis H test showed that there was a significant difference in the treatment sessions among the above 3 groups （H = 10.45, P < 0.01）, and the group with the initial area of hemangiomas < 3 cm2 showed the least treatment session. The adverse reactions were mild, and no adverse cardiovascular or respiratory events were observed. Conclusion The 595-nm pulsed dye laser combined with topical timolol maleate 0.5% solution is effective and safe for the treatment of superficial IH.

Key words: Hemangioma, Infant, Lasers, dye, Timolol, Treatment outcome, 595?nm Pulsed dye laser