Vascular Anomalies
Vascular anomalies include both acquired and inherited skin lesions. These lesions are categorized as either haemangiomas or vascular malformations and range from minor skin discolorations to large, devastating malformations.
Due to the confusion that once surrounded these conditions, vascular anomalies have historically been poorly treated. Misdiagnosis and mistreatment were frequent, and they continue to be today.
As of late, nonetheless, work on clinical information and understanding, and improved multi-disciplinary consideration, have prompted better tolerant results. Patients have access to a variety of treatment options; however, each patient’s situation is unique, so timing and judgment are essential in determining whether or not an intervention—whether surgical or nonsurgical—will be successful.
Haemangiomas A haemangioma is a benign skin growth that looks like a soft, raised swelling and is caused by an overgrowth of blood vessels. These blemishes, which are also known as strawberry naevi, strawberry haemangiomas, capillary haemangiomas, and cavernous haemangiomas, can be found anywhere on the body, but 70 percent of them are found in the neck and head area. Strawberry is the name given to them because of their slightly dimpled surface and typically dark red color.
Haemangiomas, also known as birthmarks, typically appear shortly after birth. They grow quickly over a few months, reaching a plateau around a year later before beginning to shrink and fade. By the time a child is ten, most have vanished completely, and most come and go without causing any problems.
But occasionally, haemangiomas can result in complications like bleeding, ulceration, and infection that need to be treated.
What is the treatment for haemangiomas?
Dressings and antibiotic-steroid treatments can be used to treat haemangiomas that bleed and ulcer. Despite the distressing aesthetic deformity that face haemangiomas can cause, they are typically treated conservatively during the growth phase. In the following situations, treatment will be pursued more vigorously:
• Haemangiomas which dark vision which, if untreated, can cause amblyopia, or apathetic eye;
• Haemangiomas that obstruct airways; • Multiple haemangiomas that put pressure on the heart because of increased cardiac output Steroids are the first line of treatment. They can be given orally to a patient or injected into an isolated haemangioma.
Permanent fatty remnants and loose, excess skin may remain in the case of larger or ulcerated haemangiomas. Surgery is required to restore normal function to the affected area in patients with these conditions. Haemangiomas can occasionally cause facial asymmetry, necessitating specialist plastic and maxillofacial surgery in later childhood.
Plastic specialists likewise cooperate with radiologists in specific instances of haemangioma, frequently utilizing a fruitful blend of a medical procedure and interventional radiology to treat the impacted regions.
Vascular malformations, in contrast to haemangiomas, are present at birth and do not have distinct growth or recession phases. Instead, they are categorized according to the predominant blood vessel type they contain and grow in proportion to a baby.
The most common vascular abnormalities are:
Capillary malformations, also known as port wine stains (PWS) and nevus flammeus, are birthmarks that appear on the face and last throughout a person’s life. They can happen to boys or girls. Due to the presence of dilated capillaries—the smallest blood vessels—in the dermis—the skin’s deep layer—the affected skin has a color similar to red wine. The malformation will expand in proportion to the size of the child. As an adult, it may become darker in color and have a surface that is more uneven.
Capillary malformations rarely cause any symptoms or complications besides the perceived disfigurement. Laser therapy can be very effective in treating them.
Malformations of the lymphatic system These malformations include lymphangiomas such as lymphangioma circumscriptum, cavernous lymphangiomas, and cystic hygromas. The majority of lymphatic malformations are either present at birth or will develop before the age of two, and they will not go away on their own. They affect both boys and girls equally. Their appearance is variable, from little rankle like blemishes on the skin, to enormous swellings in the neck, appendages or face. Now and again there can be draining or contamination causing unexpected expansion.
Malformations of the lymphatic system can have serious effects on the airway. Arteriovenous malformations (AVMs) are uncommon and potentially dangerous lesions that mostly occur in the scalp, head, and neck region. If treatment is required, it may involve injection into the swelling or complicated surgery. They have the potential to cause severe complications and to endanger patients’ lives. Augmentation of an AVM might be set off by injury or adolescence, and there will frequently be apparent enlarging in the skin over the impacted region, which is many times blue in variety. In the event that an AVM supposedly is developing and dying, treatment is desperately required. Sometimes, an AVM takes up so much of the patient’s blood that the heart can’t keep up. This can lead to cardiac failure and also needs to be treated right away.
There are a number of treatment options, like injecting various substances into the affected area. The goal of this treatment, which is known as embolization, is to stop blood from flowing to the lesions. Surgery is also an option, but the blood vessels involved often need to be thoroughly examined before any procedure can be performed. Even though surgical excision is the most common procedure for AVM patients, the surgeon can decide exactly what can be done and should explain the options to you at this point.
Who will I consider patient?
Because major vascular anomalies can affect any part of the body and require treatment from a variety of medical specialties, they should be managed by a multidisciplinary team. Specialists will collaborate with one another on a multidisciplinary team to ensure the best possible treatment. The following are some examples of these specialists:
• Plastic Specialist
• Vascular Specialist
• Interventional Radiologist
• Dermatologist