Vascular birthmarks, also known as vascular anomalies, refer to a group of blood vessel disorders characterized by tumors and malformations. The common infantile hemangioma is a frequent example of this condition. They are largely benign in nature, but can pose some functional and cosmetic problems. They are usually present at or around the time of birth. Some of these birthmarks, such as the common hemangioma, go away on their own, but others such as vascular malformations can continue to be a problem for a lifetime.
Treatment for vascular birthmarks can vary substantially. Dr. Panossian is Founder of the Vascular Anomalies Center at Children's Hospital Los Angeles and has extensive experience in the management of vascular anomalies of all types.
The first step is to make sure you have the correct diagnosis. Often, the initial diagnosis given to patients is inaccurate and even incorrect. Schedule a consultation with Dr. Panossian to discuss your child's condition and determine the best course of action.
This is the most common type of vascular birthmark, affecting roughly 1 in 10 children. Most hemangiomas are of the infantile type and tend to go through a well-described cycle of growth followed by involution. The treatment of hemangiomas can range from simple observation to surgical excision.
Parkes Weber syndrome (PWS) is a rare congenital vascular malformation that typically affects an extremity. They may initially appear similar to Klippel Trenaunay syndrome (KTS). However, the composition of PWS includes arteriovenous malformations (AVM) in addition to abnormal capillary, vein, and lymphatic channels.
Venous malformations are an abnormal conglomeration of veins, similar to varicose veins. They tend to gradually enlarge over time and do not disappear as hemangiomas largely do. These are not particularly dangerous but can produce disfigurement, frequent bouts of pain, and loss of muscle and/or nerve function.
Many people confuse hemangiomas with pyogenic granulomas. They are both benign vascular tumors, but pyogenic granulomas arise from some type of repetitive trauma, such as scratching, and do not disappear on their own. Surgical excision is frequently needed and relatively easy to do. They do not grow back if properly excised.
These vascular malformations are comprised of lymphatic channels. Similar to venous malformations, they can gradually enlarge over time and do not disappear. Some symptoms may include pain, redness, infection and disfigurement in severe cases. Treatment can include sclerotherapy or surgical excision.
Angiokeratoma is a condition in which small, raised, red or purple lesions appear on the skin, often mistaken for hemangiomas. These benign lesions are the result of capillary proliferations and the thickening of the skin's keratin layer.
These vascular malformations are frequently referred to as "port wine stains." They tend to involve skin and produce a deep red or purple coloration. Treatment is largely with pulsed dye laser or IPL. In some cases, capillary malformations may be associated with a larger condition called Sturge-Weber syndrome.
Rarely, vascular tumors can behave more like other soft tissue tumors, in that they can infiltrate tissues and create problems. The symptoms can be quite serious and will require a vascular anomalies expert to intervene… sometimes urgently.
There may be instances when more than one type of tissue is present in a vascular malformation. For example, capillary malformations may be present alongside venous and/or lymphatic malformations. Arteriovenous malformations are another example where abnormal arteries and veins develop together.
Vascular birthmarks are a broad term that encompasses any abnormal development of blood vessels in the skin or internal organs. These conditions can range from mild to severe, depending on the individual case. Vascular anomalies are usually present at birth and may be present for life, though they can often be managed with treatments such as laser therapy or medical interventions.
This syndrome is characterized by simultaneous involvement with capillary, lymphatic, and venous malformations. The symptoms tend to be more severe than any one of the malformations alone. There is also associated hypertrophy, or enlargement, of one or more involved limbs. Lifelong monitoring and treatment are necessary.
"Vascular birthmarks are some of the most challenging conditions to treat in medicine." They require a multidisciplinary team approach with a deep understanding of the various types of vascular anomalies.
It is important to understand that vascular birthmarks behave differently from classic birthmarks. Some require close observation and others are treated only when they create a problem. Treatment can vary widely from traditional surgical excision to sclerotherapy and embolization. The decision to treat is best done by a vascular anomalies expert.
Dr. Panossian has a deep understanding and experience in the treatment of all vascular birthmarks. He trained at the world-renowned Boston Children's Hospital Vascular Anomalies Center and established its counterpart at Children's Hospital Los Angeles.
If your child has a vascular birthmark that is growing rapidly, causing skin breakdown or ulceration, interfering with vision, breathing, or feeding, or located in a cosmetically sensitive area — it is important to have it evaluated by a vascular anomalies specialist. Early and accurate diagnosis is critical, as treatment approaches differ significantly between types.
Dr. Panossian provides comprehensive evaluation and individualized treatment plans for children with vascular birthmarks of all types. Virtual consultations are available for families outside the Los Angeles area.
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