Blood Vessel DisordersOverview, FAQs |
Physician developed and monitored. Original source: www.dermatologychannel.net
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Overview
The blood supply in the skin (cutaneous blood supply) is delivered by an interconnecting network of small arteries (arterioles), veins (venules), and tiny vessels called capillaries that connect the arterioles to the venules.
In the embryo, certain cells are responsible for stimulating blood vessel development. Simple tubelike blood vessels form first and then develop fully through the process called angiogenesis. The vasculature, or blood vessel network, is the first organ to begin developing in the embryo. Development of the vascular system continues until adulthood.
Some blood vessel disorders are the result of the overreproduction of blood vessel cells. For example, hemangioma, which typically appears soon after birth, goes through a period of rapid growth in which the blood vessel cells multiply excessively. During the period of regression during which the tumor shrinks and the skin eventually returns to a normal or near normal appearance (called involution) of these tumors, the cells gradually die off.
Other blood vessel disorders occur from vascular malformations essentially errors in development that occur between the 4th and 10th weeks of pregnancy. Most vascular malformations, such as port-wine stains, are present at birth, although some manifest years later. They tend to grow at a rate that is proportionate with the patient; however, periods of more rapid development can occur.
Q: I am pregnant and have developed numerous red bumps on my skin. What are they and will they go away?
A: Pregnancy is a time when hormonal influences can cause blood vessel changes. Some women develop excessive numbers of spider angiomas. These are tiny dilated blood vessels found in the skin's surface layer. They typically blanch when pressure is applied; when released, the blood returns rapidly. Many of these blood vessels regress after pregnancy, when hormone levels return to normal. If they don't resolve, treatment is available to eradicate them.
Q: My child was born with a port-wine stain on the side of his face. My doctor has referred him for an MRI of the brain. What is he looking for?
A: Approximately 5% of patients with port wine stains that extend onto both upper and lower eyelids are at risk for involvement of the eye, the brain, and the meninges (thin membranes that surround the brain). When this occurs, a diagnosis of Sturge-Weber syndrome is made. This syndrome is associated with seizures, glaucoma (increased pressure in the eye), and developmental delays. An MRI can diagnose this condition. In such cases, consultations with a neurologist and ophthalmologist are recommended.
Q: My child has a growing hemangioma on the forehead. While it has not become a medical problem, we are concerned about the way it looks. Can the doctor laser it off?
A: Most hemangiomas regress completely on their own with very acceptable cosmetic results. After a period of rapid proliferation, they usually remain stable and gradually disappear (involute). Approximately 50% of hemangiomas are resolved by age 5.
Laser treatment does not necessarily improve the final appearance and is mainly used with more aggressive therapies when vital structures (eyes, mouth, nose, urinary tract) are obstructed. Laser treatment effectively removes residual blood vessels after involution has occurred, and it can help hasten the healing of ulcerated hemangiomas.
Q: My daughter was born with a port-wine stain on the cheek. She is otherwise healthy. What are the recommendations for removal?
A: Facial port-wine stains are treated with laser therapy. Several sessions usually are needed. This treatment is more effective when initiated in the early years of life. Laser treatment can be painful, so a topical anesthetic is used. If this is inadequate, general anesthetic is necessary.
Q: My teenaged son has a pyogenic granuloma on his finger. It was burned out but recurred rather rapidly. What should I do next?
A: You can simply have the pyogenic granuloma (PG) burned out again. Pyogenic granulomas are notorious for recurring after treatment, because the conelike blood vessel formations extend into the skin. If a portion of the PG remains in the skin after treatment, it returns.
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