Vascular Malformations CS-OSPE
Port Wine Stain (Capillary Malformation)
Case Description/Presentation: baby who presents with a lesion on her face that has been present since birth and has been growing in size. The lesion is not itchy or painful. This is a 30-year-old fellow who presented to your clinic with this skin condition, which appeared since birth. Patient came to the clinic with this lesion since birth.
Diagnosis: Cutaneous or mucosal CM (capillary malformation) (“Port-wine” stain) Port Wine Stain / Portwine
Underlying Cause/Problem: Capillary Capillary malformation (sometimes specified as “with midline cut off”)
Description: Dull red patch on the face involving the upper eyelid, forehead, temple and scalp
Differential Diagnosis:
- Nevus simplex
- Infantile Hemangiomas (IH)
Management/Treatment:
- Full history
- Examination
- Education
- Conservative management – no treatment or use of cosmetics to conceal the lesions
- Pulse dye laser (PDL) – causes intravascular coagulation in abnormal vasculature without damaging surrounding structures
Prognosis/Progression: May develop papules, skin hypertrophy, and nodules over time.
Nevus Simplex
Look at this birthmark and answer the following questions.
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What is the most likely diagnosis and what is the underlying cause?
- Diagnosis: Nevus Simplex
- Underlying Cause: Capillary malformation
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What is the treatment of choice and what is the prognosis?
- Treatment: No need / No treatment needed
- Prognosis: Good. 90-95% of lesions resolve/fade after 1-2 years.
Infantile Hemangioma
This is a six-month-year baby boy who presented to the dermatological clinic with this condition.
- Diagnosis: Infantile hemangioma
- Due to: Benign vascular tumor
- Prognosis: Bad if segmental; it could be part of a syndrome or complicated with ulcer, visual impairment, or multifocal presentation.