Best method to treat a large po-wine hemangioma is?
Pulsed dye Laser REF: Roxburgh's common Skin Diseases 17th edition page 194 & 205, Clinical Dermatology by John Hunter, John Savin & Mark Dahl 3' edition page 275 "Selective Photothermolysis or Pulsed dye laser is the treatment of choice for Powine hemangioma" Po-wine stains are crimson blotches in which there is marked capillary dilatation compared to a capillary angioma, which is a red nodule or plaque containing proliferating endothelial cells. The latter tend to flatten and disappear at pubey. Larger ones may cause problems from bleeding and/or erosion. Cavernous haemangiomata are larger and compressible, containing large vascular spaces. Occasionally a po-wine stain of the trigeminal area is associated with a vascular malformation of the leptomeninges on the same side, which may cause epilepsy or hemiparesis (the SturgeWeber syndrome), or with glaucoma. Excellent results have been obtained with careful and time-consuming treatment with a 585-nm flashlamp-pumped pulsed dye laser. Treatment sessions can begin in babies and anaesthesia is not always necessary. If a trial patch is satisfactory, 40-50 pulses can be delivered in a session and the procedure can be repeated at 3-monthly intervals.
Radiotherapy
Tatooing
Excision with skin grafting
Pulsed dye Laser