Inflammatory nuchal-occipital port-wine stains

A port-wine stain is a congenital vascular anomaly caused by a malformation of the papillary dermal capillaries. We observed three children with an unusual appearance of their port-wine stains. All had a prominent inflammatory component consisting of scaling, excoriations, oozing, and crusting, resembling a dermatitis. In two patients, the port-wine stain occurred on the nape of the neck; in the third, it occurred over the occipital area of the scalp. Treatment with topical steroids helped to decrease the scaling and crusting, but when the steroids were stopped the inflammatory component returned. In tow patients, the lesions were treated with the flashlamp-pumped pulsed dye laser with almost total clearing of the port-wine stains and complete absence of the inflammatory component after one treatment. The recognition of this inflammatory manifestation of port-wine stains will enable earlier diagnosis and allow for effective treatment with the pulsed dye laser.