M.D. Claiborne & Associates, L.L.C. - Dermatology Specialists
The blood supply in the skin (cutaneous blood supply) is delivered by an interconnecting network of small arteries (arterioles), veins (venules), and tiny vessels called capillaries that connect the arterioles to the venules. In the embryo, certain cells are responsible for stimulating blood vessel development. Simple tubelike blood vessels form first and then develop fully through the process called angiogenesis. The vasculature, or blood vessel network, is the first organ to begin developing in the embryo. Development of the vascular system continues until adulthood. Some blood vessel disorders are the result of the overreproduction of blood vessel cells.
For example, hemangioma, which typically appears soon after birth, goes through a period of rapid growth in which the blood vessel cells multiply excessively. During the period of regression during which the tumor shrinks and the skin eventually returns to a normal or near normal appearance (called involution) of these tumors, the cells gradually die off. Other blood vessel disorders occur from vascular malformations essentially errors in development that occur between the 4th and 10th weeks of pregnancy. Most vascular malformations, such as port-wine stains, are present at birth, although some manifest years later. They tend to grow at a rate that is proportionate with the patient; however, periods of more rapid development can occur. Topical and oral steroids were once the gold standard of treatment for infantile hemangiomas, but now more effective treatments exist. In cosmetically sensitive locations such as the face, Dr. Claiborne typically opts to start an oral medication (Hemangiol) that is FDA approved for infantile hemangiomas.
Q: I am pregnant and have developed numerous red bumps on my skin. What are they and will they go away?
A: Pregnancy is a time when hormonal influences can cause blood vessel changes. Some women develop excessive numbers of spider angiomas. These are tiny dilated blood vessels found in the skin’s surface layer. They typically blanch when pressure is applied; when released, the blood returns rapidly. Many of these blood vessels regress after pregnancy, when hormone levels return to normal. If they don’t resolve, treatment is available to eradicate them. This includes injectable agents (sclerotherapy) and laser therapy.
Itching can often become severe during pregnancy – our practice is one of very few that have phototherapy. Phototherapy is a specialized wavelength of light (narrow band UVB) that can be used SAFELY in pregnancy for itching.
Q: My child was born with a port-wine stain on the side of his face. My doctor has referred him for an MRI of the brain. What is he looking for?
A: Approximately 5% of patients with port wine stains that extend onto both upper and lower eyelids are at risk for involvement of the eye, the brain, and the meninges (thin membranes that surround the brain). When this occurs, a diagnosis of Sturge-Weber syndrome is made. This syndrome is associated with seizures, glaucoma (increased pressure in the eye), and developmental delays. An MRI can diagnose this condition. In such cases, consultations with a neurologist and ophthalmologist are recommended.