Introducere, Etiologie, Histopatologic, Diagnostic clinic,

PWS are congenital capillary malformations that occur in 0.3 0.5% of live
births, grow commensurately with the child, and never regress.
Histopathology reveals increased number of ectatic blood vessels in the
dermis, with normal turnover of endothelial cells.
Etiology unknown, with altered or even absent neural modulation of the
vascular plexus with a decrease in both sympathetic and sensory nerve
innervation of the papillary plexus.
Some studies (Chang et al.) showed decrease in the nerve density in facial
PWS using confocal microscopy PWS specimens, and overexpression of
vascular endothelial growth factor (VEGF) and its receptor.
PWSs begin as flat, ping cutaneous patches predominantly located on the
head or neck.
Most PWSs are isolated lesions, but they may be associated with
complicated syndromes requiring prompt diagnosis and intervention.
PWSs are normally isolated lesions but they may be associated with
complicated syndromes like Sturge-Weber and Kippler-Trenaunay.

Prognostic
The preponderance of evidence showed that early treatment in life not
only has better outcomes but also a greater psychological impact.
Partial lesions of PWS return in 5-10 years after treatment. Data vary the
anatomical location of the lesion.
PWSs become darker in color and become increasingly nodular.
By the fifth decade of life, up to 65% of patients develop hypertrophy or
nodulariy of the lesion, and these changes are associated with a risk of
spontaneous bleeding or haemorrhage with injury to the site.
One of the most important outcome of these type of lesion is the
psychosocial impact, many patients reported low self-esteem and
difficulties in their personal relationships attributed to their vascular
lesions.
Hypertrophy of lesions in the periorbital region may obstruct vision, and in
the periorbital and nose region may interfere with eating and breathing.
Treatment
KTP
PDL

IPL
PDL
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Successive laser treatments usually performed at 4-6 week intervals