Port-wine stains

Abstract

To the Editor.—

Smoller and Rosen¹have shown morphological evidence of abnormal vascular innervation in the skin of patients with port-wine stains, and they have postulated that the progressive vascular dilatation in this condition is the result of impaired neural control. We have recently investigated reflex control of cutaneous blood flow in two patients with port-wine stains of the limbs. Our findings show that vascular reflex function in the area of the port-wine stains is impaired, and this has led us to conclude that neurologic control mechanisms are defective in these lesions. These conclusions are similar to those that Smoller and Rosen have drawn from their structural studies. Skin oxygen tension (Po₂) is a flow-related parameter that is determined by clearance principles. Measurement of transcutaneous Po₂at 37°C allows one to monitor changes in skin blood flow in response to physiologic maneuvers^2,3and pharmacologically active agents.