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Vascular Anomalies and Cutaneous Birthmarks

Hemangiomas

Hemangiomas are vascular birthmarks which often become visible a few days to a few weeks after birth.  They often appear as “blemishes” over any part of the head, neck, body and limbs, becoming more visible and raised over time.  These birthmarks continue to grow in size over several months, often stopping around one year of age.  The classic treatment for hemangiomas, in areas of the body where the birthmark can grow without invading or obstructing vital organs, is observation, because the majority of these birthmarks spontaneously regress.

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However, some hemangiomas, during the proliferative growth phase, can obstruct organs such as the eye, impairing vision.  Lesions such as these require treatment, which includes oral or injectable corticosteroid and laser.  Laser treatments are most effective when the hemangioma is only slightly elevated.

The laser beam can only penetrate to certain depths and is less effective in the very elevated lesions because it cannot reach the very big deep blood vessels to destroy them.

 

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However, the laser can be helpful in the large, painful, ulcerated hemangioma where laser treatments have been observed to alleviate the pain and contribute to healing the ulceration. 

Source: Oon Tian Tan, M.D., Ph.D.

Port Wine Stains

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Port wine stains (PWS) are pink or dark red flat vascular birthmarks, which are present at birth and are commonly found on the head and neck. They will be present for the lifetime of the individual and will not go away unless treated.  The abnormally enlarged blood vessels, which are present in the PWS, will continue to increase in size throughout a patient’s life.

 

 

 

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Lasers can be used to remove these abnormal blood vessels with minimal injury to adjacent structures such as collagen.  Individuals of any age can be treated.  Treatment should begin as early as possible, especially in children.

 

 

Source: Oon Tian Tan, M.D., Ph.D.

Nevus of Oto and Ito

Nevus of Oto and Ito are blue-gray patches on the face and shoulder consisting of pigment in the dermis suggesting that these pigments have remained in the dermis instead of the epidermis where they are normally found.  These lesions can either be congenital or acquired.  Lasers, especially those in the “red,” such as the Alexandrite and Ruby and even the Nd:Yag, have been effective in removing the misplaced melanocytes (pigment cells) in the dermis, thus lightening the blue-gray patches.
 

Café au lait

Cafe au lait (CAL) spots are hyper pigmented lesions of varying sizes which may be light to dark brown.  The presence of these lesions may be associated with congenital conditions such as neurofibromatosis.  Typically, CAL spots are present at birth, although they may be difficult to notice. By the time a child is aged 2-3 years, CAL spots are clearly visible.  The size and number of CAL spots increase with age.  Because CAL spots are the result of an increase in melanin (pigment) in the giant pigment cells (melanosomes), the pigment within the cells can be destroyed by certain lasers such as the Alexandrite, Ruby and Nd:YAG.

  
After
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