timolol (Ophtim / timolol, Thea)

Topical timolol in the treatment of pediatric pyogenic granuloma: A 23-case series.

Sánchez Pulido L J LJ, Vega Mata N N, Enríquez Zarabozo E M EM, Granell Suárez C C et al.

Pyogenic granuloma (PG) is a common benign vascular lesion in pediatric patients, characterized by rapid growth and a tendency to bleed. Surgical excision allows immediate resolution and histological confirmation, with low recurrence when including the base of the lesion, although it may require anesthesia and leave a scar. Topical timolol has emerged as a conservative alternative in selected patients. To evaluate the efficacy and safety of topical timolol 0.5% in the treatment of PG in pediatric patients. Retrospective case series of 23 pediatric patients (4 months-13 years) diagnosed with PG and treated between 2018 and 2024 with a 0.5% timolol formulation applied topically over the lesion as an off-label use. Demographic and clinical variables, treatment duration, final response, need for surgery, recurrence, and documented adverse events were analyzed. Ten patients (43.5%) achieved complete or near-complete resolution of the lesion, 6 (26.1%) showed a partial response at the end of treatment or prior to surgery, 5 (21.7%) did not respond or exhibited progression, and 2 (8.7%) were still receiving treatment at data cutoff. Twelve patients completed treatment without surgery; at cutoff, 14 (60.9%) had not undergone surgery, including the 2 cases still under treatment. Nine patients (39.1%) required surgery. No recurrences were documented among patients with complete or near-complete resolution during available follow-up, and no adverse events attributable to treatment were recorded. Topical timolol 0.5% can be considered an initial conservative alternative in selected pediatric patients, especially when avoiding or deferring surgery or anesthesia is desired. Surgery remains a definitive option, offering immediate resolution and the possibility of histological confirmation. Prospective comparative studies are needed to define more precisely the role of timolol compared to surgical treatment.

Vision-Threatening Giant Hemifacial Infantile Hemangioma Successfully Treated with Oral Propranolol and Topical Timolol.

Sarkar Sumantra S, Bandyopadhyay Rakhi R, Raza Arsalan A

Clinical Outcomes of Nasal Tip Infantile Hemangiomas: A Retrospective Cohort Study.

Belmesk Lina L, Coulombe Jerome J, Powell Julie J, Tehrany Yassaman Alipour YA et al.

Infantile hemangiomas (IH) are the most common vascular tumors in infancy. Nasal tip infantile hemangiomas (NTIH) are associated with high-risk disfigurement and long-term sequelae. Despite widespread use of propranolol, optimal management of NTIH remains incompletely defined. A retrospective cohort study included patients with NTIH evaluated between 2003 and 2019 at a pediatric referral center. Inclusion required confirmed diagnosis by two pediatric dermatologists, available clinical photographs, and ≥ 6 months of follow-up. Data collected included demographics, IH subtype, treatments, adverse events, and sequelae at 3 years old. Propranolol-treated patients were stratified by dose (≤ 2.5 vs. > 2.5 mg/kg/day). Fifty-eight patients met inclusion criteria. Propranolol was prescribed in 72.4% (n = 42), with a mean duration of 16.0 months. Adverse effects were predominantly mild (sleep disturbances, 20.7%). At 3 years of age, sequelae, particularly fibroadipose tissue, were significantly less frequent in propranolol-treated patients compared to those untreated (42.9% vs. 91.8%, p = 0.005; overall sequelae: 67.9% vs. 100%, p = 0.037). Sequelae rates did not differ between low- and high-dose propranolol groups. Combined propranolol and topical timolol was associated with increased telangiectatic sequelae, likely reflecting treatment selection bias. No association was found between IH subtype and sequelae. Systemic propranolol was associated with fewer long-term sequelae in NTIH, particularly fibroadipose tissue. A lower dose of 2 mg/kg/day appears sufficient in most cases. Topical timolol may provide limited additional benefit and should not delay propranolol initiation. These findings support early systemic propranolol as the standard of care in NTIH management.

Locus Coeruleus Stimulation Enhances Object Recognition Memory Persistence After Early-Life Stress Independent of Hippocampal Noradrenergic Signaling.

Neves Ben-Hur Souto das BSD, Lima Karine Ramires KR, Rosa Ana Carolina de Souza da ACSD, Gomes Gabriela Cristiane Mendes GCM et al.

Early-life stress, such as maternal deprivation (MD), is a stressor that can lead to cognitive deficits in adulthood. Among the neurochemical mechanisms involved in MD-induced pathophysiology are alterations in the dopaminergic and noradrenergic systems. We recently demonstrated that pharmacological stimulation of dopaminergic neurons in the ventral tegmental area (VTA) improves novel object recognition (NOR) memory in rats subjected to MD. Furthermore, projections from the locus coeruleus (LC) to the dorsal hippocampus (DH) are important for memory consolidation. From postnatal day (PND) 1-PND10, male and female rats were either subjected to MD or left undisturbed. In adulthood, the animals underwent stereotaxic surgery for bilateral cannulation of the DH and LC. Following recovery and habituation, the animals were trained in the NOR task and immediately received vehicle or timolol in the DH, and either vehicle or NMDA in the LC. NOR memory was assessed at 24 h, as well as 7 and 14 d after training, to evaluate memory consolidation and persistence, respectively. MD impaired NOR memory in male rats, but not in females. Pharmacological stimulation of the LC with NMDA promoted NOR memory persistence in both non-MD and MD males and females. In males, LC stimulation also reversed the MD-associated memory impairment. These effects were maintained despite hippocampal β-adrenergic receptor blockade with timolol. These findings suggest that LC-related pathways contribute to the processing of NOR memory persistence following early-life stress in a sex-dependent manner. This effect appears to be independent of hippocampal β-adrenergic signaling.