Vascular malformations

Types

  1. Capillary
  2. Venous
  3. Lymphatic

Common features

  1. Develop as abnormal proliferation of embryonic vascular network
  2. Hamartomas
  3. May ulcerate
  4. May induce hyperkeratosis in overlying stratum corneum layer of skin

 

Lesion
Appearance Description
Campbell de Morgan spots
  • Small red capillary naevus
  • Develops on the trunk in middle age
  • No clinical significance
Spider naevi
  • AKA naevus araneus
  • A form of telangectasis
  • central arteriole with leg-like branches which blanche on central pressure
  • Found over upper torsom head and neck in adults (distribution of superior vena cava)
  • Associated with chronic liver disease and malignancy
  • >5 considered as pathological in chronic liver disease
Telangectasia
  • Dilation of normal capillaries
  • Can be secondary to skin irradiation
  • Can be part of hereditary haemorrhagic telangectasia (Olser-Rendu-Weber syndrome) - rare AD disease causing overt and occult haemorrhage can occur presenting as haematuria, haematemesis, maelaena, epistaxis or IDA
Port-wine stain
  • AKA naevus venosus
  • Purple-blue naevus found on face, lips, mucous membranes of mouth
  • Present from birth and does not change in size therafter
  • Found on limbs in association with Klippel-Trenaunay syndrome
  • Sturge-Weber syndrome is association of facial port-wine stain witha corresponding haemangioma in the brain, leading to contralateral focal seizures
Strawberry patch
  • Cavernous haemangioma
  • Bright red raised "strawberry-like" lesion
  • Present from birth
  • 60% undergo spontaneous resolution by age of 3
  • Only treated if obscuring visual field or spontaneous resolution not occuring