Summary
Our present histological knowledge of the port-wine stain is limited because of the small size of biopsies taken in the past. During the last two decades, Clodius has performed subtotal excision of port-wine stains, and has covered the defects with full thickness skin grafts. The availability of large surgical specimens of dermis affected by port-wine stain prompted the present study. Specimens from 50 locations were obtained in 28 patients. The pathomechanism of the port-wine stain was found to be telangiectasia of normal capillaries, sometimes congenital abnormal increase of the number of cutaneous vessels, or both. The theory of gradual age-dependent transformation of port-wine stain is true in regard to the colour of the affected skin, but is not valid in regard to the parallel increase of the vessel lumina and RBC filling grade. One-third of the patients below the age of 30 had the wide type lesion. The extreme histological differences in the size of the abnormal vessels, and the percentage of vascular area filled with RBC's were repeatedly noted in the different regions of the face in the same patient. Furthermore, even within the same area, the histology of port-wine stain varies greatly. The value of the small biopsies presently used for the assessment of laser treatment for these lesions is questioned.
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References
Apfelberg DB, Vistnes LM (1987) Treatment of hemangioma and lymphangioma. In: Georgiade NG, Georgiade GS, Riefkohl R, Barwick WJ (eds) Essentials of plastic, maxillofacial, and reconstructive surgery. Williams and Wilkins, Baltimore, pp 187–194
Barsky H, Rosen S, Geer DE, Noe JM (1980) The nature and evolution of PWS: a computer-assisted study. Invest Dermatol 74:154
Bossard K (1918) Die blassen Feuermale der Kinder. Jahrb Kinderheilkd 88:204
Brown JB, Cannon B (1945) Full-thickness skin grafts from the neck for function and color in eyelid and face repairs. Ann Surg 121:639
Clodius L, Smahel J (1970) Por 8, a new vasoconstrictor substitute for adrenaline in plastic surgery. Br J Plast Surg 23:73
Clodius L (1977) Excision and grafting of extensive facial haemangiomas. Br J Plast Surg 30:185
Clodius L (1985) Surgery for the extensive facial port-wine stain? Aesthet Plast Surg 9:61
Clodius L (1986) Surgery for the facial port-wine stain: technique and results. Ann Plast Surg 16:457
Cordova A (1981) The Mongolian spot. Clin Pediatr 20:714
Crepeau RJ (1983) Haemangioma syndromes. In: Williams HB (ed) Symposium on vascular malformations and melanotic lesions. Mosby, St Louis, pp 21–26
Gonzales-Ulloa M (1957) Restoration of the face covering by means of selected skin in regional esthetic units. Br J Plast Surg 9:212
Grabb WC, MacCollum MD, Tan NG (1977) Results from tattooing port-wine hemangiomas. Plast Reconstr Surg 59:667
Graefe CF (1808) Angiectasie, ein Beitrag zur rationellen Cur und Erkenntnis der Gefässausdehnungen. Kohler, Leipzig
Landthaler M, Dorn M, Haina D, Kleipzig K, Waiderich W, Braun-Falco O (1983) Morphologische Untersuchungen zur Behandlung von Naevi Flammei mit dem Argonlaser. Hautarzt 34:548
Lever WF, Schaumburg-Lever G (1983) Tumours of vascular tissue. In: Histopathology of the skin, 6th edn. Philadelphia, pp 623–625
Malan E, Puglionisi A (1965) Congenital angiodysplasias of the extremities (Note II: Arterial, arterial and venous and hemolymphatic dysplasias). J Cardiovasc Surg 6:255
Malm M, Jurell G, Glass J-E (1988) Argon laser treatment of port-wine stain. Scand J Plast Reconstr Hand Surg 22:245
Moretti G, Ellis RA, Mescon H (1960) Vascular patterns in the skin of the face. J Invest Dermatol 33:103
Niechajev IA, Karlsson S (1982) Angiomatosis osteohypotrophica. Scand J Plast Reconstr Surg 16:77
Noe JM, Barsky SH, Geer DE, Rosen S (1980) Port-wine stains and the response to argon laser therapy: successful treatment and the predictive role of colour, age and biopsy. Plast Reconstr Surg 65:131
Noe JM, Olbricht SM (1986) Lasers in plastic surgery. In: Habal MB (ed) Advances in plastic and reconstructive surgery, vol 2. Year Book Medical Publishers, Chicago, pp 156–163
Ohmori S, Huang CK (1981) Recent progress in the treatment of port-wine staining by argon laser: some observations on the prognostic value of relative spectro-reflectance (RSR) and the histological classification of the lesions. Br J Plast Surg 34:249
Pasyk KA (1987) Classification of hemangiomas. Argon laser treatment of port wine stains. In: Ryan TJ, Cherry GW (eds) Vascular birthmarks. Pathogenesis and management. University Press, Oxford, pp 36, 130–147
Rank B (1976) Cutaneous vascular naevi of the face port-wine stains. In: Marchac D, Hueston JT (eds) Trans VI Int Congr Plast Reconstr Surg, Paris, pp 661–665
Schnyder UW (1954) Zur Klinik und Histologie der Angioma. 2. Mitteilung: Naevi telangiectatici. Arch Dermatol 198:75
Schnyder UW (1955) Zur Klinik und Histologie der Angioma. 1. Mitteilung: Zur Histologie des Naevus flammeus (Naevus telangiectaticus). Arch Dermatol Syph 200:483
Stern RS (1983) Clinical syndromes associated with port wine stains. In: Arndt KA, Noe JM, Rosen S (eds) Cutaneous laser therapy: principles and methods. Wiley, Chichester, pp 75–84
Tan KL (1972) Nevus flammeus of the nape, glabella and eyelids. Clin Pediatr 2:112
Williams BH (1980) Vascular neoplasms. Clin Plast Surg 7:397
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Niechajev, I., Clodius, L. Histology of port-wine stain. Eur J Plast Surg 13, 79–85 (1990). https://doi.org/10.1007/BF00177812
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DOI: https://doi.org/10.1007/BF00177812