Enlargement and proliferation of previously regressed hemangioma following administration of inhaled salbutamol

Infantile hemangioma is the most common benign vascular tumor of childhood. It does not always require treatment but, when indicated, propranolol is the treatment of choice to reduce its size. However, there are factors, some better known than others, that can favor the growth of the hemangioma, such as administration of salbutamol, a drug widely used for daily treatment in clinical practice. Salbutamol is a selective beta-2 adrenergic agonist that causes vasodilation through the release of nitric oxide and stimulates the synthesis of proangiogenic factors. We present the case of a patient with involuted infantile hemangioma that fully and rapidly rebounded with the administration of inhaled salbutamol for management of an episode of obstructive bronchitis.