Systemic propranolol and topical moist wound dressings for ulcerated infantile hemangioma of the scrotum: a case report

Background Ulceration is a common complication of infantile hemangioma, and its management poses unique difficulties when the lesion is located in high-risk areas like the scrotum. This case report details the successful management of this condition using topical moist wound dressings combined with propranolol. Case presentation A 5-month-old male presented with a rapidly progressing, ulcerated scrotal infantile hemangioma characterized by purulent exudate. Systemic treatment involved oral propranolol solution (maintenance dose of 2 mg/kg/d). Local wound care was managed using a tailored moist wound healing strategy: alginate dressing combined with recombinant human epidermal growth factor gel, secured with a transparent film dressing. The patient was treated successfully; localized infection was controlled within 3 days. The wound achieved complete epithelialization after a total of 12 days of consistent combined treatment, accompanied by simultaneous regression of the hemangioma volume. Three-month Follow-up confirmed favorable cosmetic results with no significant hypertrophic scarring. Conclusion This case underscores that a synergistic regimen of systemic propranolol and a customized moist wound healing strategy can significantly accelerate healing timelines and improve the quality of tissue repair in ulcerated infantile hemangiomas.