My daughter is 5 months old and has a PWS on her left calf. It is currently about 6 cm long, but grew from 4 cm at birth. Her pediatrician says not to worry, but I do. Should I take her to another doctor? If so, who?
Originally Posted by PresidentVBF
First, remember that we are learning new things every day about port wine stains.
Port wine stains come in various grades and those grades relate to the depth of the vessels.* Grade I are shallow and respond well to laser therapy and Grade III have deep vessel involvement and don't respond as well. With the more shallow stains you can see good skin peeking through and these are called "geographic" port wine stains.* These stains respond very, very well to laser therapy and people often report a complete "clearance" of these stains. There is actually a stain that is a little less than a Grade I which has resolved completely with laser therapy and after many years the individuals report that it has not come back. This is about as close we can get to a cure. Since lasers have not been around long enough, or at least the good lasers, we don't know if they are truly "cured" although some docs use that word. Stains that are deeper, like the Grade II and III have a mix of geometric and confluent stains.* The confluent are solid...solid...solid and are Grade III. You will get lightening and these will even "break up" the stain and give you some fleshy spots, but the stain will be there after 10 treatments because the laser can only penetrate 1mm and can't reach the thicker, deeper vessels. So, you see stain because it is there, way down below the 1mm level.* The Grade II lesions that are a mix will have some pretty good resolution and a little make up will make them almost disappear but these come back in time as the the Grade III and some of the Grade I lesions.* Only a small number of people with very, very superficial port wine stains (very shallow vessels) report to recurrence. So, can we call them cured? Some say yes. Some say that in time when the women hit menopause and the men are in their 40s and 50s they will come back but only time will tell. When we have a good 20 years of information we will know what is and what is not cured.* Also, the cause is in the nervous system and it makes the vessels constrict and dialate so it would not make sense that a laser could "cure" the deficiency in the nervous system, although it could make the "stain" appear to NOT BE THERE.* What I am saying is that it is there, but way down deep.