A fraction of deep vascular birthmarks are true deep hemangiomas of infancy.
BACKGROUND
Deeply-located vascular birthmarks have been traditionally regarded as being identical to a deep type of hemangioma of infancy (HOI). However, there is increasing evidence that some venous malformations also mimic these deep type of HOIs clinically. This study investigates how many, if not all, deep vascular birthmarks are deep type HOIs.


METHODS
Nineteen cases were selected on the basis of the clinical features of deeply-located vascular birthmarks. Hematoxylin-eosin slides were reviewed and immunohistochemistries were performed using CD31, D2-40 and GLUT1 to confirm diagnoses before they were compared with the clinicoradiologic review by specialists other than dermatopathologists.


RESULTS
Only 4 patients out of a total of 19 cases were strongly positive for GLUT1 staining and turned out to be true deep HOIs. The remaining were comprised of 6 venous malformations (31.6%), 3 lymphatic malformations (15.8%), 1 glomangioma (5.3%) and 5 tufted angiomas (26.3%).


CONCLUSIONS
It was demonstrated that all deeply-located vascular birthmarks are not true deep HOIs. It is recommended that diagnosis for HOI be carried out cautiously earlier in life using GLUT1 in addition to clinical features. This would help prevent patients from being misled by anticipating the spontaneous involution in all deeply-located vascular birthmarks.
Lee
Seok-Jong
SJ
Department of Dermatology, Vascular Anomalies Clinic, Kyungpook National University School of Medicine, Daegu, South Korea. knuderma@hanmail.net
Shin
Dong Ju
DJ
Kim
Ho Youn
HY
Lee
Weon Ju
WJ
Kim
Do Won
DW
Chung
Ho Yun
HY
Baik
Seung Kug
SK
Lee
Jong Min
JM
Huh
Seung
S
Yoon
Ghil Suk
GS
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D051272:Glucose Transporter Type 1 / Q000378:metabolism; D006391:Hemangioma / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007223:Infant; D008208:Lymphatic System / Q000002:abnormalities; D008297:Male; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D012867:Skin / Q000098:blood supply* / Q000473:pathology*; D054079:Vascular Malformations / Q000378:metabolism / Q000473:pathology*; D019043:Vascular Neoplasms / Q000378:metabolism / Q000473:pathology*; D014680:Veins / Q000002:abnormalities
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; D019408:Platelet Endothelial Cell Adhesion Molecule-1; C495677:SLC2A1 protein, human; C500987:monoclonal antibody D2-40