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Capillary Malformation Follow-up

  • Author: Richard J Antaya, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Aug 20, 2014


Occasionally capillary malformations are complicated by an overlying eczematous dermatitis. The mechanism for this is unknown but has been compared with stasis dermatitis, given the dilated dermal capillaries in each condition. The dermatitis is quite responsive to topical steroids or topical calcineurin inhibitors; however, it readily recurs shortly after discontinuation of treatment. Laser ablation of the underlying capillary malformation successfully treats this dermatitis.[49]


Patient Education

Patients and parents benefit from an organized, informative, multidisciplinary effort to address psychological, medical, and surgical needs for optimal outcomes from medical care, especially surgical or laser procedures.

In the author's experience, a frank discussion with the affected child's classmates early in the school year is most beneficial. A brief classroom discussion, which can be facilitated by the patient's parent or teacher, offers an opportunity to educate the child's classmates about the birthmark and to reassure them that it is neither painful nor contagious. Once the capillary malformation has been explained adequately and questions answered, most children cease to further question the child. This helps to alleviate some of the patient's psychological burden.

Buddy Booby's Birthmark, by Evan Ducker, a child with a capillary malformation, and his mother, Donna Cardenia Ducker, is a children's picture book depicting a baby booby bird on the Galapagos Islands that was born with a capillary malformation (birthmark) on his beak. It is the first children's book of its kind to depict the social stressors associated with facial capillary malformations. It is available for purchase at

Contributor Information and Disclosures

Richard J Antaya, MD Director of Pediatric Dermatology, Professor, Departments of Dermatology and Pediatrics, Yale University School of Medicine

Richard J Antaya, MD is a member of the following medical societies: American Academy of Dermatology, Society for Pediatric Dermatology, American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Van Perry, MD Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio

Van Perry, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Mark W Cobb, MD Consulting Staff, WNC Dermatological Associates

Mark W Cobb, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society of Dermatopathology

Disclosure: Nothing to disclose.

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Histopathologic features of a capillary malformation (nevus flammeus) showing telangiectatic vessels lined by mature-appearing endothelial cells.
Capillary malformation on the left preauricular aspect of the cheek, the ear, and the neck in a neonate (same patient as in Media Files 3-4).
Same patient as in Media Files 2 and 4 immediately after test spots with the pulsed-dye laser at 585 nm. Note the purpuric macules where the laser impacted in a linear distribution on the preauricular aspect of the cheek.
Same patient as in Media Files 2-3 after 4 treatments with the pulsed-dye laser. Treatments were given at 2-month intervals in an outpatient setting using topical anesthetic.
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