Haemangiomas and superficial vascular malformations.

Haemangiomas are different from true superficial vascular malformations. Th e haemangiomas, mainly affecting the newborn and small babies, will, after a phase of progression, sometimes regress completely. Therapeutic abstentio n is the rule except in high risk angiomas when steroid therapy may be effe ctive. Visceral involvement poses problems. Superficial vascular malformations, on the other hand, arise at all ages an d may affect any blood vessel. Each type has a specific clinical presentati on, complementary investigations and appropriate treatment. Some are slowly progressive, for example capillary, venous and lymphatic malformations. Ot hers are haemodynamically active, such as the arteriovenous malformations. Capillary malformations are fiat angiomas with aesthetic consequences, apar t from the Sturge-Weber-Krabbe syndrome. Cold, blue venous malformations co nfirmed by ultrasonography and magnetic resonance imaging, when necessary, require treatment adapted to their site and size : compression, embolisatio n, surgery or abstention. Lymphatic malformations may be cystic or tissular : the cystic lymphangioma, a soft swelling of often healthy skin, with com partments separated by septa on ultrasound scan, is usually treated by ethi bloc embolisation. Arteriovenous malformations, warm and pulsatile, demonstrated at arteriogra phy, may progress rapidly and treatment by surgery or embolisation, when ne cessary, has to be complete. Finally, there are complex vascular malformati ons which pose very difficult problems of management.