Back Dermatological Conditons

Port-Wine Stain葡萄酒色斑

A port-wine stain or naevus flammeus is a vascular birthmark consisting of superficial and deep dilated capillaries in the skin which produce a reddish to purplish discoloration of the skin. They are so called for their colour, resembling that of port wine. It is part of the family of disorders known as vascular malformations.

Port-wine stains are present at birth and persist throughout life. The area of skin affected grows in proportion to general growth. Port-wine stains occur most often on the face but can appear anywhere on the body. Early stains are usually flat and pink in appearance. As the child matures, the color may deepen to a dark red or purplish color. In adulthood, thickening of the lesion or the development of small lumps may occur.

What is a port-wine stain?

A port-wine stain is a red or purple mark on the skin. It is usually present from birth. About 3 in 1000 babies are born with a port-wine stain. Most occur on the face but any area of the skin can be affected. Port-wine stains affect males and females equally. They are not hereditary.

What do port-wine stains look like?

Port-wine stains vary in size from a few millimetres across to many centimetres. Their colour can vary from pale red to deep purple. If left untreated, port-wine stains tend to darken over the years as the blood flow through them becomes more sluggish. The overlying skin is smooth and flat at first. By middle age the overlying skin can become thickened and lumpy (a 'cobblestone' appearance).

What causes port-wine stains?

A port-wine stain is a localised blood vessel problem. The tiny blood vessels (capillaries) in port-wine stains remain dilated (wide). It is like a permanent localised blush. The reason why this occurs is thought to be due to a damaged or faulty nerve supply to the affected tiny blood vessels. The nerve impulses that make the blood vessels narrower are lost so they then stay wide all the time.

What are the symptoms of port-wine stains?

Apart from their appearance, no other symptoms or problems occur in most cases.

However, about 1 in 10 babies born with a port-wine stain on the face have problems of the eye or brain.

• Eye problems may develop if the port-wine stain is on the eyelid area. If a child has a port-wine stain next to an eye then an eye specialist will normally check the child regularly until they are adult.
• Brain abnormalities are an uncommon association with port-wine stains of the face. This is due to extensive blood vessel abnormalities in the brain. (The Sturge-Weber syndrome.) Epilepsy and other problems may then develop.

The majority of children with port-wine stains do not have these complications.

What is the treatment for port-wine stains?

Occasionally, port-wine stains improve and fade without treatment, particularly when the forehead and eyelids are affected. Laser treatment is usually the treatment of choice for port-wine stains, especially in children.

Laser treatment

Treatment with a laser leads to variable improvement. A special fine laser can destroy the tiny widened blood vessels. Laser treatment may not clear the port-wine stain completely and repeat treatments are often needed over the years to come. Features of laser treatment include the following.

• Treatment works best in young children when the port-wine stain is new and flat. Children as young as two months old can be treated. It works less well in adults who have had a port-wine stain for a number of years which may have become bumpy and raised.
• Treatment tends to work best on smaller port-wine stains of the face and less well on the arms and legs.
• Generally, the paler the port-wine stain, the greater the chance of excellent results.
• The laser can cause an unpleasant stinging. Therefore, younger children usually have laser treatment under a general anaesthetic or with sedation. Local anaesthetic is normally sufficient for older children and adults.
• Up to 10 treatments are needed depending on the size. Treatments are given about eight weeks apart. It is best to have completed all sessions before a child reaches five years.

There may be pain, bruising and swelling over the treated area for a while after each session.