An 8-week-old boy develops progressively worsening biphasic stridor without fever. Examination reveals a large haemangioma over the chin, mandibular skin and anterior neck. Endoscopy confirms a compressible vascular lesion in the subglottis. First-line systemic therapy is:

• A Intralesional bleomycin
• B Oral propranolol ✓
• C Oral prednisolone as definitive long-term therapy
• D Immediate tracheostomy in all cases

Explanation

Subglottic haemangioma typically declares itself between 6 and 12 weeks with biphasic stridor, and about half of affected infants have cutaneous haemangiomas. B 'beard distribution' haemangioma strongly predicts airway involvement. Propranolol is now the established first-line systemic agent, having replaced corticosteroids as definitive therapy. Tracheostomy is reserved for lesions failing medical therapy or causing critical obstruction, not routine initial management.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.