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J Am Acad Dermatol. 2009 Apr;60(4):669-75. doi: 10.1016/j.jaad.2008.11.020. Epub 2009 Jan 23.

Physiologic changes in vascular birthmarks during early infancy: Mechanisms and clinical implications.

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  • 1Department of Dermatology, Division of Pediatric Dermatology, University of California, San Francisco, California 94115, USA.


Vascular birthmarks are the most common birthmarks encountered in newborns. Many dermatologists are unfamiliar with the normal physiologic changes that affect and alter their appearance during early infancy. In this article we discuss normal newborn hemodynamic/neurovascular physiology and the associated clinical findings in neonatal skin. The physiologic anemia of infancy and its resultant effects on skin color and the appearance of vascular birthmarks are detailed. Finally, the pitfalls and obstacles to early diagnosis of vascular birthmarks and the subtle differences between them are reviewed, as are the challenges in assessing response to early pulsed dye laser treatment in the context of the changing vascular physiology.

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