Evolving trends in the treatment of vascular birthmarks

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 r

Contact: Marcelo Hochman, M.D.
JAMA and Archives Journals

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