Effectiveness and side effects associated with Doxycycline as sclerotherapyin pediatric head and neck lymphangiomas

Abstract

Introduction: Common side effects of doxycycline include diarrhoea, itch and skin sensitivity. Doxycycline makes your skin more sensitive, so it's extra important to protect your skin from the sun, if you are taking it. Lymphangiomas are the congenital malformations of the lymphatic system which are benign in nature. They are classified as microcystic (capillary lymphangiomas), macrocystic (cavernous lymphangiomas) and cystic hygromas. Objective: To assess the effectiveness of intralesional Doxycyline sclerotherapy in pediatric head and neck lymphangioma. Methods: This was a retrospective review of chart of all children who underwent Doxycycline sclerotherapy for lymphangiomas of head and neck region in six months duration between January to June 2023. A total of 50 cases were treated with intralesional doxycycline. Medical records were reviewed and evaluated for following variables like age, sex, history, examination findings including site of lesion, ultrasonographic findings, number of injection, dose of Doxycycline and any side effectsnoted and the final outcome of sclerotherapy. Results: There was complete resolution of the macrocysticlesion infourcases (12.0%) after two sessions of Doxycycline sclerotherapy. The partial resolution of lymphangioma occurred in 31 cases (62.0%) with mixed type of lymphangioma whereas, in 13 cases (26.0%), there was no response observed even after six sessions of sclerotherapy. Minor side effects like local site erythema and swelling were observed in 31 cases. Secondary infection was seen in 13 cases. Six patients developed fever after injection which was resolved within 24 hours. Conclusion: Doxycycline sclerotherapy is safe and effective in the treatment of head and neck lymphangioma in the pediatric population. DS has distinct advantages over other sclerotherapy agents including that it is inexpensive and widely available, and has minimal side effects.