A 6-year-old boy is brought in to clinic by his parents with a deep purple
lesion over his right zygoma. It has been present since birth and he is
otherwise well. On examination it extends over the entire cheek and is lumpy and
thickened on palpation. There is no associated lymphadenopathy. Most probable
a. Strawberry naevus
b. Deep capillary naevus
d. Superficial spreading melanoma
Correct Answer: b Deep capillary naevus
These are also known as port-wine stains and are formed by capillaries in the
upper and deeper dermis. Together with superficial capillary naevi (stork
marks), it belongs to the group of vascular naevi.
Most occur on the head and neck and tend to be unilateral, often appearing in
the territory of one or more branches of the trigeminal nerve.
They can be extensive and cosmetically disfiguring. At birth they can vary from
pink to dark purple, darkening over time. Lumpy angiomatous nodules may also
develop within the lesion.
Often these lesions can be lasered with reasonable results. There are some
- associated intracranial vascular malformation resulting in convulsions
and delayed development, known as SturgeWeber syndrome
- congenital glaucoma if lesion occurs in ophthalmic division of
- hypertrophy of underlying tissues, eg the limb, causing abnormal growth
known as haemangiectatic hypertrophy.