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The Management of cutaneous hemangiomas is a much debated subject. Opinions diverge, both as to the need of any treatment at all to these benign blood-vessel tumors and as to the choice of possible therapy and the time at which it should be instituted. It is generally agreed that some hemangiomas undergo spontaneous involution. For this reason, Lister (33) expressed the view that treatment is indicated only in exceptional cases. Many investigators, however, agree with Traub (46), who believed that spontaneous regression is relatively rare, so that treatment during the first year of life must be recommended. On the basis of their comprehensive case material, Watson and McCarthy (48) concluded that all hemangiomas should be treated as early as possible, an opinion which most writers share. The reasons for this attitude are: (a)It is impossible to predict whether a particular hemangioma will disappear spontaneously or continue its growth, and the size of the ultimate scar will increase with that of the heman...

There are three common types of vascular nevi; namely, the capillary hemangioma (port wine stain), hemangioma simplex (strawberry mark), and the cavernous hemangioma. Spontaneous involution may occur. There is also the tendency for some hemangiomas to grow very large and to become ulcerated. If ulceration occurs, sepsis as well as cosmetic defects may ensue. Delay in starting treatment while waiting for spontaneous involution may provoke serious problems. The cosmetic appearance of the treated site is usually the most important consideration, and, accordingly, early institution of treatment and the prevention of secondary infection are recommended.

One hundred plastic planing operations on the skin by means of a motor-driven wire brush were reviewed. Complications noted were pruritic erythematous eczematous dermatitis on a possible autosensitization basis, hyperpigmentation and milia. These occurred in a small proportion of cases and in no case were they permanent sequelae. Flat postacne scarring is more easily improved than steep "ice-pick" type scars. The planing procedure is contraindicated in the management of certain tumors of the skin, portwine nevi, decorative tattoos, and generalized dermadromes. The psychiatric and emotional impact of the patient's scarring on his personality is often a great one and the operator must bear in mind that plastic planing is no panacea for a severely neurotic patient. Therefore it is important that patients be carefully selected and that improvement rather than complete cure be stressed.

Although vascular nevi are generally considered to be inherited, 1 pedigrees do no seem to have been published. Actually, the genetic background has been essentially derived from the study of the occurrence of these nevi in twins. 2 In particular, nevus flammeus has but rarely been reported to have been inherited. Siemens 3 and Cockayne, 4 in their comprehensive surveys on heredity in cutaneous diseases, cited but a single known instance in which nevus flammeus appeared in parent and child. Their reference was to Benedict, 5 who described a family in which the mother had a large discontinuous portwine stain on the right side, involving the chest, arm and shoulder, while 1 of her 5 children presented a large portwine stain covering the right side of the chest and neck and the right arm. Strangely, even though nevus flammeus of the nape of the neck is seen in 5 per

In 1879, Sturge pointed out the probable association of a “portwine mark” on the face with Jacksonian convulsions. Weber, in 1922, described the characteristic calcification within the skull, consisting of double contoured lines following the convolutions of the cerebral cortex. Brushfield and Wyatt described the same condition in 1928. Schwartz showed that these occurred commonly in the parietal and occipital regions.

Sturge-Weber syndrome is a neurocutaneous syndrome characterized by port wine stain, congenital glaucoma, and underlying anomalous leptomeningeal venous plexus and the lack of normal cortical venous drainage. It is a congenital but not an inherited disease and it occurs sporadically and is very rare, incidence being approximately 1 on 50000. It occurs with rare exception but occasionally the other members of the family may have hemangiomata of a lesser degree. DOI: 10.3126/jnps.v30i3.3920J Nep Paedtr Soc 2010;30(3):164-165

The obliteration of nevus flammeus (port-wine stain) presents a problem for which neither surgical excision nor the various methods of nonsurgical treatment have provided a satisfactory solution. The psychological importance of nevus flammeus to the person who bears this birthmark is frequently so great as to have adverse effects on his personality and social adjustment. It is, therefore, especially unfortunate that the methods of treatment in general use fail to bring about the necessary cosmetic obliteration of this congenital deformity. The nonsurgical procedures that have been employed include electrodesiccation, cauterization, distance application of ultraviolet light, and use of carbon dioxide snow, liquid air, ignipuncture, electrolysis, ultraviolet therapy with a Kromayer lamp, x-ray therapy, or radium therapy. All these methods must be applied to the lesion through the overlying skin, with consequent injury to or destruction of the skin and subcutaneous tissue. Thus, the nevus flammeus is replaced by scarring, which

Angiomas are tumors of endothelial origin and rarely are they malignant. The neoplastic process arises in buds of endothelial tissue which may grow extensively but do not seem to connect with normal vessels in the surrounding tissue. But one afferent and efferent channel is ascribed to the angioma, and occlusion of either should eventuate in regression of the lesion. TYPES OF LESIONS Excepting nevus flammeus ("port wine stain"), a large majority of hemangiomas will spontaneously involute at a relatively early age, but therapy is frequently warranted. This applies to both the superficial ("strawberry mark") and deep ("cavernous") hemangiomas, which two varieties are most commonly observed and frequently occur in combination. Nevus flammeus, nevus araneus (stellate or "spider" angioma), senile angiomas, lymphangiomas and more rare forms are not included in this discussion. INDICATIONS FOR THERAPY' Most strawberry and cavernous angiomas are either present at birth or appear within the first few

G LAUCOMA associated with nevus flammeus has been described in ophthalmologic literature from time to time, but apparently little reference is made in dermatologic reviews. This report adds but 1 more case to a still relatively small series of reported cases. It is also intended to awaken interest in the dermatologist who has an opportunity to see many cases of facial nevi. REPORT OF A CASE A 24 year old master sergeant was admitted to a general hospital on Sept. 17, 1942. Two months prior to admission he had appeared for a routine examination. He was found to have defective vision. The patient stated that he had always been fond of hunting and in his "teens" was a good marksman. About 1939 (three years before admission) his aim became inaccurate because of blurred vision. In 1940 glasses were prescribed by a nonmedical refractionist. His vision apparently remained the same