Successful long-term therapy of Stewart-Bluefarb syndrome

The Stewart-Bluefarb syndrome is defined as an unilateral angiodermatitis d ue to multiple arterio-venous fistules accompanied by acroangiodermatitis r esembling Kaposi sarcoma (pseudo-kaposi sarcoma). The acroangiodermatitis i s most common on the lower limb. It leads to ulcerated nodules with a high risk of bleeding and infection, as well as edema, pain and seldom limb hype rtrophy. Curative therapy requires elimination of the arteriovenous shunts. Surgical destruction of the multiple small fistulae is a limitating factor . A better alternative is embolisation, but this approach carries the risk of ischemia and necrosis. A 32 year old female patient with Stewart-Bluefar b syndrome is presented; she has been successfully treated with embolisatio n on eight occasions.