VASCULAR BIRTHMARKS

SCH Vascular Birthmarks Clinic Patient Information

The Sydney Children’s Lymphangioma and Vascular Birthmarks Clinic was established in 1997 with the aim of combining the expertise of medical and allied health specialists in the management of all types of vascular birthmarks. The aim of the clinic is to provide excellence in diagnosis, individually tailored up-to-date treatments and long term monitoring of these many and varied birthmarks.

No vascular birthmark is the same as another. They may involve any internal organ as well as the skin, and therefore no single specialist is capable of caring for every aspect. Your doctor may have sent you for an opinion or may wish for your child to continue under the care of the Vascular Birthmarks Team. The core Vascular Birthmarks Team includes specialists from Dermatology, Radiology, Paediatric Surgery, Plastic & Reconstructive Surgery, Ear Nose & Throat Surgery, Immunology, Haematology, Cardiology Nursing, Social Work and Physiotherapy. In addition, the skill of other specialists is available when required.

When you come to the clinic, you can expect an explanation as to the nature of your child’s birthmark and the symptoms and changes to expect with time. The Team will give you an idea of the investigations that may be required to confirm the diagnosis and its extent, and the treatment options available. Photographs will also be
taken. It can be quite daunting coming to a consultation with so many specialists at once but their combined expertise is essential and you should feel free to ask any questions at any time.

Vascular birthmarks fall into 2 categories - (1) Haemangiomas (2) Vascular Malformations

What is a Haemangioma and how is it different from a Vascular Malformation?
Haemangiomas occur in the skin and, rarely, in the internal organs and may be multiple. They are usually not present at birth but develop in the first weeks of life. After this they grow rapidly for a number of months, before stabilising and then they slowly go away. Half have disappeared by the age of 5 and most by the age of 9.

Vascular Malformations, on the other hand, are actually present at birth (although they are not always obvious). They grow in proportion to the child and never go away spontaneously. They can be made of capillaries, veins, arteries, lymph vessels or a combination of two or more vessel types. Some malformations, such as capillary (Port Wine Stains) cause only a change in skin colour while others are large and distorting. The various types of malformations have different characteristics, different growth patterns, different associated problems and different treatments.

This reinforces the need for an accurate diagnosis and individually tailored treatment.

How are Haemangiomas treated?
Most Haemangiomas require no therapy at all and go away completely on their own. Some, however, do cause
problems and require specialised treatment. The Vascular Birthmarks Team and your doctor will monitor your child and advise you which investigations and treatments, if any, are needed. Investigations include blood tests, and specialised X Rays and scans. Treatment may include medications, dressings, physiotherapy, an injection to block the blood flow, an operation or a combination of these. A new medicine is being trialled in a study.

How are Vascular Malformations treated?
The management of a Vascular Malformation must be tailored according to its type and site and to any associated problems. Often no particular therapy is needed initially, but this can change with time. The specialists may recommend investigations such as specialised X Rays and scans. Treatment, when indicated, may include Physiotherapy, Laser, an injection to block the blood flow, an operation, or a combination of these.

A special word about Laser
The Flashlamp-Pulsed Dye Laser is the gold standard for the treatment of Port Wine Stains. The Laser at Sydney Children’s Hospital was generously donated by the Christopher Robin Committee, making the Sydney Vascular Birthmarks Clinic the first dedicated paediatric facility in NSW to offer this treatment. The Laser works by emitting pulses of light which are selectively absorbed by the pigment in red blood cells. This means the abnormal vessels causing the birthmark are destroyed without scarring of surrounding tissues.

What other support is available?
It is often difficult for parents to deal with their own responses to their child’s condition, in addition to the responses of other people. Our social worker is available to discuss this and other issues with you, as well as to help ensure any questions you have of the specialist are answered. Practical help is available for patients travelling from outside Sydney to attend the Vascular Birthmarks Clinic, including accommodation and financial assistance.

Further information
Please contact the Vascular Birthmarks Clinic if you have other questions or you wish to make an appointment for your child to be assessed at the Vascular Birthmarks Clinic.

Vascular Birthmarks Clinic Department of Paediatric Surgery
Sydney Children’s Hospital
High Street,
Randwick, 2031
Telephone 9382 1776
Fax 9382 1787
Email: SCHVBC@sesiahs.health.nsw.gov.au