Vascular lesions

The more common vascular naevi are described.

The port wine stain, or naevus flammeus, presents at birth as a flat red lesion, usually on the face, neck, or upper trunk. There is usually a sharp midline border on the more common unilateral lesions. In time the affected area becomes raised and thickened because of proliferation of vascular and connective tissue. If the area supplied by the ophthalmic or maxillary divisions of the trigeminal nerve is affected there may be associated angiomas of the underlying meninges with epilepsy—Sturge-Weber syndrome. Lesions of the limb may be associated with arteriovenous fistulae.

Cavernous angioma—strawberry naevi—appear in the first few weeks of life or at birth. A soft vascular swelling is found, most commonly on the head and neck. The lesions resolve spontaneously in time and do not require treatment unless interfering with visual function.

Spider naevus consist of a central vascular papule with fine lines radiating from it. They are more common in children and women. Large numbers in a man raise the possibility of liver disease.

Campbell de Morgan spots are discrete red papules 1-5 mm in diameter. They are more common on the trunk.

Pyogenic ¡granuloma is a lesion that contains no pus but is in fact vascular and grows rapidly. It may arise at the site of trauma. Distinction from amelanotic melanoma is important.

Verrucous epidermal naevus

Naevus sebaceous

Naevus sebaceous

Epidermoid cyst

Verrucous epidermal naevus

Epidermoid cyst

Naevus flammeus

Sturge-Weber syndrome

Naevus flammeus

Sturge-Weber syndrome

Further reading

Pyogenic granuloma

Further reading

Enzinger F, Weiss S. Soft tissue tumours, 2nd ed. St Louis: Mosby, 1988

Mackie RM. Skin cancer: an illustrated guide to the etiology, clinical features, pathology and management of benign and malignant cutaneous tumours, 2nd ed. London: Martin Dunitz, 1996

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