Evolving trends in the treatment of vascular birthmarks

September 19, 2005

The September/October issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals, contains several articles on the current state of knowledge and experience with vascular birthmarks, which are caused by blood vessels that do not form correctly. Vascular birthmarks can be internal, or form an external birthmark and can be disfiguring, especially if formed on the face. In an editorial accompanying the articles, Marcelo Hochman, M.D., of The Facial Surgery Center, Charleston, S.C., writes that more than 400,000 infants in the United States are born with a vascular lesion, including hemangiomas (which include "strawberry" or "raspberry" marks and port wine stains) and various malformations.

"The gap between the perpetuated beliefs about these lesions ('Lleave it alone; it will go away') and the current state of our knowledge and experience is very wide," Dr. Hochman writes. "By disseminating the various viewpoints in this issue we hope to slowly help bridge that gap. Our patients will continue to benefit from the advances in management espoused by the authors until a consensus about treatment is eventually reached."

In Description and Analysis of Treatments for Port-wine Stain Birthmarks, Kristen M. Kelly, M.D., of the University of California at Irvine, and colleagues present the current treatment approaches for port-wine stains using pulse-dye laser therapy, which currently offers the most effective treatment, the authors suggest, with its ability to selectively target blood vessels.

Rami K. Batniji, M.D., of the Albany Medical College, Albany, N.Y., and colleagues present an algorithmic approach to the management of facial hemangiomas in An Aesthetic Approach to Facial Hemangiomas. They review the natural course, classification and history of treatment of these lesions throughout the past 100 years. Observation may be all that is necessary for stable lesions, the authors suggest, but superficial lesions that are growing rapidly, ulcerating or functionally limiting may require intervention with pulsed laser therapy; deep lesions may require treatment with corticosteroids; and involuting (rolling inward) hemangiomas may require surgery.

Vascular malformation of the head and neck may cause not only significant cosmetic defects but also functional impairment of structures such as the eye, tongue or throat, John P. Deveikis, M.D., of the Medical University of South Carolina, Charleston, reports in Percutaneous Ethanol Sclerotherapy for Vascular Malformations in the Head and Neck. Although surgical treatment is traditionally recommended, Dr. Deveikis suggests that the benefits of surgery may be limited when healthy structures are intimately involved with the lesion. In the article, he presents a study on the evaluation and treatment of patients with vascular malformations of the head and neck using an alternative, minimally invasive treatment.

In Management of Nasal Hemangiomas, Marcelo Hochman, M.D., of The Facial Surgery Center, Charleston, S.C., and Alfredo Mascareno, M.D., an International Visiting Fellow, Guadalajara, Mexico, report their extensive experience treating infantile hemangiomas involving the nose. They present a comprehensive review of the management of these lesions.

Two short articles, Current Knowledge of the Pathogenesis of Infantile Hemangiomas and Hemangiomas of Infancy present the current understanding of the natural course of infantile hemangiomas, the most common benign tumor of infancy, review the common characteristics of ulcerated infantile hemangiomas and discuss treatment options.

Finally, in Congenital Hemangiomas, Alfons Krol, M.D., F.R.C.P.C., and Carol J. MacArthur, M.D., of the Oregon Health and Science University, Portland, describe congenital hemangiomas, much more rare and only recently described hemangiomas, as they differ from infantile hemangiomas in their presentation, natural history and treatment. Juan Carlos Lopez-Guiterrez, M.D., and colleagues from the University of Madrid, Spain, provide a case study of in Giant Rapidly Involuting Congenital Hemangioma of the Face of a rare congenital hemangioma with a 15-year follow-up.
Media Advisory:
To contact Marcelo Hochman, M.D., e-mail hochman@facialsurgerycenter.com
To contact Kristen M. Kelly, M.D., Tom Vasich at 949-824-6455.
To contact Rami K. Batniji, M.D., call Beth Engeler at 518-262-3421.
To contact John P. Deveikis, M.D., call Ellen Bank at 843-792-2626.
To contact Alfons Krol, M.D., F.R.C.P.C., call Tamara Hargens at 503-494-8231.
To contact Juan Carlos Lopez-Guiterrez, M.D., e-mail queminfantil.hulp@salud.madrid.org.

The JAMA Network Journals

Related Blood Vessels Articles from Brightsurf:

Biofriendly protocells pump up blood vessels
In a new study published today in Nature Chemistry, Professor Stephen Mann and Dr Mei Li from Bristol's School of Chemistry, together with Associate Professor Jianbo Liu and colleagues at Hunan University and Central South University in China, prepared synthetic protocells coated in red blood cell fragments for use as nitric oxide generating bio-bots within blood vessels.

Specific and rapid expansion of blood vessels
Upon a heart infarct or stroke, rapid restoration of blood flow, and oxygen delivery to the hypo perfused regions is of eminent importance to prevent further damage to heart or brain.

Flexible and biodegradable electronic blood vessels
Researchers in China and Switzerland have developed electronic blood vessels that can be actively tuned to address subtle changes in the body after implantation.

Lumpy proteins stiffen blood vessels of the brain
Deposits of a protein called ''Medin'', which manifest in virtually all older adults, reduce the elasticity of blood vessels during aging and hence may be a risk factor for vascular dementia.

Cancer cells take over blood vessels to spread
In laboratory studies, Johns Hopkins Kimmel Cancer Center and Johns Hopkins University researchers observed a key step in how cancer cells may spread from a primary tumor to a distant site within the body, a process known as metastasis.

Novel function of platelets in tumor blood vessels found
Scientists at Uppsala University have discovered a hitherto unknown function of blood platelets in cancer.

Blood vessels can make you fat, and yet fit
IBS scientists have reported Angiopoietin-2 (Angpt2) as a key driver that inhibits the accumulation of potbellies by enabling the proper transport of fatty acid into general circulation in blood vessels, thus preventing insulin resistance.

Brothers in arms: The brain and its blood vessels
The brain and its surrounding blood vessels exist in a close relationship.

Feeling the pressure: How blood vessels sense their environment
Researchers from the University of Tsukuba discovered that Thbs1 is a key extracellular mediator of mechanotransduction upon mechanical stress.

Human textiles to repair blood vessels
As the leading cause of mortality worldwide, cardiovascular diseases claim over 17 million lives each year, according to World Health Organization estimates.

Read More: Blood Vessels News and Blood Vessels Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.