Explaining infantile haemangioma, propranolol and safety-netting — OSCE

Candidate instructions (8-minute station)

You are the paediatric registrar in the clinic. A 2-month-old infant has a rapidly growing, bright-red raised haemangioma on the upper eyelid that appeared at three weeks of age and has enlarged over six weeks. The parents have read about propranolol on the internet and are anxious. [2]

Your tasks are: [2]

1. Explain what the lesion is and what the natural history will be, in plain language. [2]
2. Explain why this particular lesion needs treatment and why you will use oral propranolol. [1]
3. Explain the propranolol safety-netting — the hypoglycaemia risk and what to watch for. [7]
4. Explain the long-term plan and what may remain after the lesion has involuted. [11]

You are not expected to perform the PHACE imaging yourself in the station, but you should explain that further checks are part of the plan because the lesion is large on the face. [7]