Today we will dedicate this blog to a very common problem in the thick world of pediatric dermatology: vascular spots. Those spots that many children present at birth and that some of them keep in their adult life, colloquially known as “cravings”.
In relation to those “cravings” that many patients say their mothers had during pregnancy, we must first say that they are real lesions derived from the blood vessels and that they can be of two different types. The most common are undoubtedly the so-called hemangiomas or angiomas, however there is another not so infrequent group, which are called vascular malformations. Let’s talk a little about each of them and their differences and characteristics.
Infantile hemangiomas, also known as “strawberry” angiomas or capillary hemangiomas, are absolutely benign vascular lesions that appear in the first months of life and most frequently affect girls and low birth weight newborns. In 80% of children they are single lesions but in up to 20% of cases they can be multiple and affect any body area, being more frequent in the head and neck (60%) followed by the trunk and the perineal region. They are very showy lesions, with an intense red “wine red” coloration, very well delimited and oval morphology, sometimes they can simulate a strawberry, hence their name.
Despite the diversity of size and location, these lesions follow a common pattern of evolution, with an initial phase of rapid growth between 3 and 9 months, followed by a stabilization phase of variable duration and an involution phase that will last several years (up to 4-5 years approximately). The regression of hemangiomas is complete or almost complete in 95% of cases, with practically no residual lesion, therefore no treatment is required in most cases and only biannual visits to the office will be necessary to follow the evolution. In cases of large hemangiomas or in certain locations such as the nose, lip or eye, imaging studies and medical treatment will be necessary.
Therefore, when faced with an angioma, the first thing to do is not to be alarmed and to be patient, because in the transition from baby to child, in less time than you realize, the lesion will have practically disappeared. In the case of residual reddish spots, we can perform laser treatment if the aesthetic implications would weigh too heavily.
And the other group of vascular lesions, perhaps not as well known as the previous ones, are vascular malformations that correspond to alterations in the formation of blood vessels during embryonic development, and therefore are lesions that appear at birth and will be persistent throughout life, undergoing growth proportional to the child’s development. The most frequent of this group are hair malformations and of these the most frequent are the so-called “salmon spot” that appears in the occipital region (“stork’s peck”) or in eyelids and eyebrows (“angel’s kiss”).
They usually present clinically as more or less faint, poorly demarcated reddish spots, may affect any area of the integument and become more evident with crying, fever or when the child is irritated. Sometimes they adopt a linear or segmental arrangement and may affect an entire limb. In these cases, ultrasound studies should be performed to rule out other associated malformations, and in terms of treatment, very good aesthetic results are obtained with laser.
First of all, calm and tranquility, both types of vascular spots do not imply any risk for the full development of your children. It is logical to consult a dermatologist to guide you towards one or the other diagnosis given the divergent evolution of both vascular lesions.