Port-wine stains and eczema

Sir, Port‐wine stains (PWS) are congenital vascular malformations of developmental origin, characterized pathologically by ectasia of superficial dermal capillaries and clinically by persistent macular erythema.1 We have witnessed 16 children with PWS and overlying eczematous skin changes. Laser therapy to the PWS was associated with an improvement in the eczema, and we postulate that the increased vasculature predisposes to the development of eczema. The observation that these inflammatory changes occur within the PWS may help in our understanding of the pathophysiology of eczema. The children fell into two categories: those with a history of atopic eczema (n = 7) and those with no history of eczema and in whom the eczematous skin changes were limited to the area of the PWS (n = 9). Of the children with a history of eczema, three were girls and four were boys, with a mean age of 9 months. The PWS were localized to the face and/or neck (n = 5), the leg (n = 1) and extensively on the face and body (n = 1). Two of the children had the Klippel–Trenaunay syndrome, two had associated glaucoma and one child had cutis marmorata telangiectatica congenita. All of these children had eczematous lesions within the PWS on presentation to the clinic. The eczematous changes were confined within the borders of the PWS, with a tendency to be most marked around the periphery. These children had areas of eczema elsewhere on the body and received conventional treatment with emollients and a mild or moderate topical steroid preparation.