Birthmark treatment ‘life-changing’
Current treatment is only used in the most serious cases, but, writes Melanie Carroll, a cream being developed in NZ could treat all children with the benign tumours.
WHEN Heather was born, she looked just like any other baby. Within days, a strawberry birthmark started to appear on her nose and within seven weeks it grew so quickly it was affecting her breathing.
Fortunately for Heather and her family, she was one of the first children to access revolutionary treatment in a clinical trial from Dr Swee Tan and his team at Gillies McIndoe Research Institute (GMRI).
‘‘She was gorgeous, and we had no health concerns at all,’’ said her mother, Karen Jenkinson.
‘‘Four days after she was born, there was a very slight blush on her nose, but we didn’t really think much of it.’’
Her obstetrician first pointed it out and suggested they get it checked. After a visit to the GP and then a paediatrician,
Heather was diagnosed with an infantile haemangioma, or strawberry birthmark.
‘‘It was getting worrying because by the time she was seven weeks old, it was quite big,’’ Jenkinson said.
‘‘The nose was very misshapen, and little babies under three months don’t breathe through their mouths, they just breathe through their noses.’’
Strawberry birthmarks are benign but fast-growing vascular tumours, appearing mostly around the head and neck. But they can put children at risk depending on where they develop.
In Heather’s case, the tumour was growing inside and outside her nose, and was interfering with her feeding.
Originally treatment included steroids, plastic surgery, or chemotherapy. Tan and his team realised that beta-blockers used
to treat blood pressure could also shrink strawberry birthmarks, and Heather became part of a trial that resulted in oral propranolol becoming the standard treatment.
‘‘Having this ability to work out how the propranolol turned off the tumour and regressed it was just life-changing for us, really,’’ Jenkinson said.
‘‘There was no question, we were keen to participate. We felt all the way through that we were in the best hands possible, and we could see from the information they provided and told us that this was a really good option.’’
She was also delighted they had been part of a trial that would help many other children.
Heather’s strawberry birthmark reacted very quickly, beginning to reduce within about six months and disappeared completely within 18 months.
Now aged 13, Heather remembers lots of doctors’ visits but not a lot else about that time. But looking at the photos of herself as a baby, she is glad there was a solution for her strawberry birthmark.
‘‘I’m just really grateful to Professor Swee Tan for
everything. It’s been amazing.’’
The oral treatment had to be given every eight hours, which often meant waking a sleeping baby during a time of already very little sleep for parents. There was also the worry about giving her the wrong amount, as she sometimes could not keep it down.
Jenkinson welcomed the potential of a topical cream currently at the early stages of development.
‘‘Putting a drug into your 7-week old baby that they didn’t need for blood pressure, I would have much preferred a cream. That would have been just one less thing to worry about.’’
New Zealand company AFT Pharmaceuticals has reached an agreement with the Gillies McIndoe institute and Massey University’s commercialisation
company, Massey Ventures, to develop a topical treatment for strawberry birthmarks in children.
Dr Clint Gray, chief scientist at the institute, said the existing treatment had some potential side-effects, including bronchitis, sleeping disorders and heart rhythm disorders, which meant it was used only in the most
serious cases.
Smaller strawberry birthmarks could eventually disappear by themselves, but the larger ones could leave scarring, both physical and emotional.
‘‘There’s a massive need for the topical treatment for both the severe and just across the board, everyone can use it. Whereas at the minute, existing treatments are only used in the extreme circumstance,’’ Gray said.
A topical treatment would be simple and safe to administer, and could be applied earlier with lower side-effect risk, and would enable earlier treatment in all strawberry birthmarks.
Strawberry birthmarks affect about 10% of Caucasian babies and about 5% or more infants globally. One of the most common complications for children is ulceration.
Dr Hartley Atkinson, AFT managing director, said it was an opportunity to help improve the treatment of children with disfiguring birthmarks, to innovate locally, and also an attractive global commercial opportunity.
Development of the topical treatment would take a good five years and would cost ‘‘quite a few million dollars’’, Atkinson said.
AFT will work with Massey Ventures and the GMRI to finalise the ingredients for the topical treatment and will then lead a full medicine development programme including clinical studies
There was no guarantee of success, but the data looked promising so far, he said.
‘She was gorgeous, and we had no health concerns at all. Four days after she was born, there was a very slight blush on her nose, but we didn’t really think much of it.’ MUM KAREN JENKINSON