Early pulsed-dye laser treatment of childhood haemangiomas

who also randomised and treated the patients, and is a member of a centre where observation is the standard management strategy for haemangiomas. The quality of the study would have derived much benefit from the inclusion of a clinical observer without this association. The independent medical observer who assessed the redness of the lesion by looking at colour photographs is not an equivalent substitute. Only the data for complete and almost complete remission are shown, although detailed information on the other outcomes (partial remission, cessation of growth, and progression) would have been desirable. To treat benign lesions which show good cosmetic results after spontaneous regression with a risky treatment is as bad as withholding a safe therapy which could stop haemangioma proliferation and accelerate involution. Batta and colleagues have made an important first step, but we agree with Ulrich Hohenleutner and Michael Landthaler that further randomised prospective studies are needed to settle this important issue. *Harald Maier, Peter Donath, Reinhard Neumann