Table of Contents
Overview – Vascular Skin Lesions
Vascular skin lesions are congenital or early-onset abnormalities of blood vessels in the skin. They can be benign proliferations like haemangiomas or malformations such as port-wine stains. Although most vascular lesions are harmless, they can have aesthetic or functional implications depending on size, location, and persistence. This guide provides a high-yield summary of the key vascular skin lesions, including their clinical features and management. Recognition of vascular lesions is essential for medical students in both paediatric and dermatological contexts.
Haemangiomas
Aetiology
- Congenital lesion that typically manifests after birth
Epidemiology
- Most common vascular tumour in infancy
- Often appear within the first weeks of life
Pathophysiology
- Benign proliferation of vascular endothelial cells
- Classified as a benign vascular tumour
Clinical Features
- Soft, red to blue subcutaneous mass
- Compressible and blanching with pressure
- Rapid growth during infancy, followed by involution
- Around 50% resolve spontaneously by age 5
Management
- Many require no treatment
- Intervention considered if:
- Lesion persists into school age
- There is functional impairment, ulceration, or cosmetic concern
- Options:
- Topical timolol
- Oral propranolol
- Corticosteroids (less commonly used)
- Laser therapy
- Surgical excision (for refractory or residual lesions)
Port-Wine Stains (Capillary Malformations)
Aetiology
- Congenital vascular anomaly
Epidemiology
- Present at birth
- Rarely associated with Sturge-Weber syndrome (especially if facial)
Pathophysiology
- Malformation of dermal capillaries
- Unlike haemangiomas, they do not proliferate or regress
Clinical Features
- Red or purple macules
- Follow a dermatomal distribution
- Typically unilateral; rarely crosses the midline
- Common locations:
- Nape of the neck
- Face
- Extremities
- Persist throughout life; may darken or thicken with age
Management
- Pulsed dye laser therapy is the treatment of choice
- Multiple sessions often required
- Early treatment may yield better cosmetic outcomes
Summary – Vascular Skin Lesions
Vascular skin lesions such as haemangiomas and port-wine stains are common paediatric skin presentations with distinct clinical courses. Haemangiomas are benign vascular tumours that often resolve spontaneously, while port-wine stains are capillary malformations that persist and may require cosmetic laser therapy. Recognition and appropriate monitoring of vascular lesions are key aspects of paediatric dermatological care. For a broader context, see our Skin & Dermatology Overview page.