Large ulcerated hemangioma treated with topical timolol drops

Infantile hemangiomas (IH) are the most common benign tumors of infancy and undergo spontaneous remission by about four to five years of age. Usually, only superficial and uncomplicated hemangiomas are treated by topical timolol while larger and complicated hemangiomas require oral propranolol or corticosteroids. Uncommonly reported in the literature is that even larger complicated IHs on low-risk sites can be treated with timolol drops locally. Our case is unique, as we treated a large ulcerated IH with oral and topical antibiotics and only topical timolol drops with rapid and complete resolution of symptoms.