Types of Vascular Birthmarks

Arteriovenous Malformation (AVM)

• AVM’s are usually present at birth
• Sometimes they don’t appear until adulthood
• Can be acquired after direct trauma
• Complex mass of veins and arteries – vessels enlarge and thicken and increased blood flow to the area results
• Firm mass – when pressed feel soft and gel-like, can feel pulse or heartbeat, can cause pain
• Lips, head and neck are common areas affected
• Can also occur in the brain, brain stem or spinal cord
• Angiography used to detect AVM
• Treatment by skilled physician only – combination of embolization and surgical excision usually recommended

Café au lait Spot

• Flat patches
• Occur anywhere on body
• Tan to light brown
• Permanent
• If child has several spots, consult doctor

Cavernous Hemangioma

• Bluish or bluish-red in color
• Lumpy mass
• Borders not visible as with other hemangiomas
• Grows fast during first 6 months – then slows
• 95% disappear by 10-12 years of age
• Treatments are the same as for strawberry hemangioma

Congenital Pigmented Nevi

• Appear as hairy moles
• Can vary in color – light brown to dark/almost black
• Giant pigmented nevi are not as common as small ones
• Large nevi should be examined for malignancy

Hemangioma

• Reddish in color
• 83% occur on the head and neck area
• Occur 5 times more often in females
• Some visible at birth or within 1 to 4 weeks after birth
• Can grow for up to 18 months, then start to involute
• Involution can last 3 – 10 years
• Some can be life threatening – interfere with eating, breathing, seeing, hearing, speaking, cause strain on heart
• Internal hemangiomas can be very dangerous and hard to detect – some internal lesions require no treatment and shrink in time
• If more than 3 hemangiomas are present, entire body scan should be done

Lymphatic Malformation

• Excess fluid accumulates causing lymphatic vessels to enlarge
• Sponge-like masses of abnormal channels and spaces containing clear fluid
• Leakage from skin can occur – can lead to cellulitis
• If lymph vessels in face affected, face will swell
• Can occur anywhere on body but most common in head and neck area
• In mouth area, looks like frog eggs
• Can increase and grow with the individual
• Only skilled surgeon should treat
• MRI and CAT scan are used to diagnose
• Laser treatment, sclerotherapy, and surgery used to treat or remove

Mongolian Spot

• Blue or slate grey in color
• Resemble bruises
• Common in babies of races with dark skin (African/African-American, Mediterranean, Asian or Indian descent)
• Can be found on buttocks, back and sometimes legs and shoulders
• No treatment needed – usually fade over time

Port Wine Stain or Nevus Flammeus

• Red or purple in color
• Can appear anywhere on body
• Most are readily visible at birth - congenital
• Can be flat or slightly raised
• Usually permanent
• Laser treatment used to help reduce color, and to improve the texture of the skin (helps to prevent nodules and pws growth which can affect lips, gums and other tissues)

• Salmon-colored
• Sometimes called “angel kiss” or “stork bite”
• Most often found on the nape of the neck
• Also appear on the forehead, upper eyelids, and around the mouth and nose
• More than 95% lighten and fade completely

Strawberry Hemangioma

• Vascular malformation
• Red, soft, raised appearance
• Size varies
• May be present at birth or first few weeks thereafter
• Will grow, but start to fade (involute), turn grey in color
• Usually disappear between ages 5-10
• Surgery might be necessary to remove – depending on size and location of lesion
• Other treatments – compression and massage, steroids, X-ray therapy, laser therapy, cryotherapy, or injection of hardening agents

Venous Malformation

• Abnormality of the large deep veins, sometimes mistaken for hemangioma
• Can be deep or superficial – deep can have no color but show a protruding mass
• Jaw, cheek lips and tongue are most common areas affected
• Soft to the touch, color disappears and empties when the lesion is compressed
• When a child cries or is lying down the lesion expands and the vessels fill and the color becomes more intense
• Venous stain is a type of flat birthmark that is bluish in color and comprised of enlarged venular vessels – sometimes blebs appear and can pop and bleed
• Slow, steady enlargement – it will grow – some things cause more rapid growth such as serious sickness, trauma, infection, hormone changes (puberty, pregnancy, menopause)
• Partial removal is not recommended as these lesions will grow back

For more information on vascular birthmarks, contact the Vascular Birthmarks Foundation

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