Prognosis and response to laser treatment of early-onset hypertrophic port-wine stains (PWS)

J Am Acad Dermatol. 2016 Jul;75(1):64-8. doi: 10.1016/j.jaad.2016.02.1167. Epub 2016 Mar 19.

Abstract

Background: There is limited information regarding early development of soft-tissue and/or bone hypertrophy with facial port-wine stains (PWS).

Objective: We sought to characterize patients with hypertrophic PWS presenting during childhood.

Methods: Patients with a facial PWS and underlying hypertrophy that developed before the age of 18 years were included in a multicenter retrospective study. Age at onset of the hypertrophy, its location, association with odontologic problems, presence of other associated complications, and response to laser treatment were recorded.

Results: A total of 98 patients were included. The mean age at onset of hypertrophy, retrieved for 77 of 98 patients, was 5.6 years. The hypertrophy was congenital in 26%. Odontologic problems were noted in 39.8% of cases. Other complications, including cataract, asymmetric development of the maxillary bone, and speech delay/disorders, were reported in 18.4%. In all, 67 patients received laser treatment. Only 3% achieved complete or nearly complete clearance of the PWS.

Limitations: As only cases of PWS with early-onset hypertrophy were included, we were unable to calculate the prevalence of this manifestation.

Conclusion: PWS with early-onset hypertrophy are associated with a high rate of complications and a poor response to laser treatment. Periodic monitoring is recommended for early detection and treatment of complications.

Keywords: complications; hypertrophic; laser; odontologic problems; port-wine stains; speech delay.

Publication types

  • Multicenter Study

MeSH terms

  • Abnormalities, Multiple* / diagnosis
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Face
  • Female
  • Humans
  • Hypertrophy / congenital
  • Hypertrophy / pathology
  • Hypertrophy / surgery
  • Infant
  • Lasers, Dye / therapeutic use*
  • Male
  • Middle Aged
  • Neck
  • Port-Wine Stain / complications
  • Port-Wine Stain / pathology*
  • Port-Wine Stain / surgery*
  • Prognosis
  • Retrospective Studies
  • Young Adult