Topic Resources
Image provided by Thomas Habif, MD.
© Springer Science+Business Media
Port-wine stains (or nevus flammeus) are flat, reddish to purple lesions appearing anywhere on the body, and commonly affecting the face, scalp, neck, or extremities (1). Lesions become darker and more palpable with time (often becoming quite hyperplastic by late middle age), but the lateral extent increases only in proportion to the growth of the patient. Port-wine stains of the trigeminal area may be a component of Sturge-Weber syndrome (in which a similar vascular lesion appears on the underlying meninges and cerebral cortex and is associated with a variety of neurologic and ocular abnormalities such as seizures and glaucoma).
General reference
1. Escobar K, Pandher K, Jahnke MN: Capillary malformations. Dermatol Clin 40(4):425-433, 2022. doi: 10.1016/j.det.2022.06.005
Diagnosis of Capillary Malformations
The diagnosis of capillary malformations is primarily based on clinical evaluation.
Depending on findings, imaging studies including an MRI with contrast of the brain may be indicated to diagnose associated syndromes (eg, Sturge-Weber syndrome) or to exclude vascular malformations such as a leptomeningeal angioma.
Treatment of Capillary Malformations
Vascular laser treatment or cosmetic creams
Treatment with vascular lasers produces excellent results in many cases, especially if the lesion is treated as early in life as possible (1). Initiating pulsed dye laser treatments at earlier ages may be associated with better outcomes (ie, diminished nodularity and tissue hypertrophy) (2).
The lesion can also be hidden with an opaque cosmetic cream prepared to match the patient’s skin color.
Treatment references
1. DeHart AN, Richter GT: Laser treatment of vascular anomalies. Dermatol Clin 40(4):481-487, 2022. doi: 10.1016/j.det.2022.06.002
2. Sabeti S, Ball KL, Burkhart C, et al. Consensus Statement for the Management and Treatment of Port-Wine Birthmarks in Sturge-Weber Syndrome. JAMA Dermatol. 2021;157(1):98-104. doi:10.1001/jamadermatol.2020.4226
