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Hypertrophic port-wine stains associated with older patients
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Older patients with port-wine stains were at an increased risk for developing hypertrophy in a retrospective study.
Using medical records and clinical photographs, researchers in the Netherlands studied 335 patients (231 women) with port-wine stains (PWS) between September 2005 and March 2009. At database screening, the median age of the patients was 22 years, and the most common PWS location was the face (68%), primarily the cheeks. Red (49%) was the most common PWS color.
Sixty-eight patients (20%; 95% CI, 16%-24.6%), including 36 women, were identified as having hypertrophic PWS. At database screening, the median age of this subgroup was 50 years. Hypertrophic PWS was most common on the face (79%), with the majority of cases involving cheeks. Red (50%) was the most reported color, followed by purple (44%). Pink was rarely seen. The researchers classified hypertrophy as thickened (25%), nodular (40%), or thickened and nodular (35%), with both types presented equally on the body and face.
Using univariate regression analyses, older age was greatly associated with hypertrophic PWS (OR=1.09 per year; 95% CI, 1.065-1.108), while PWS size and location were not statistically significant. Adjusting for significant risk factors, such as sex, PWS color and location, age retained its association with a higher risk for hypertrophic PWS (OR=1.1 per year; 95% CI, 1.072-1.124). Forty-eight of the 335 patients were older than 50 years, including 34 with PWS hypertrophy (71%; 95% CI, 56.9%-82.3%). Nodular hypertrophy and combined (diffuse and nodular) hypertrophy primarily were observed in patients aged 41 to 60 years.
Of the 68 hypertrophic PWS patients, 63 (93%) returned questionnaires about their condition. The median age reported among 44 respondents on the onset of their hypertrophic PWS was 31 years. The median ages at onset of nodules and diffuse thickening were 39 and 12 years, respectively.
“More attention should be drawn to therapy and prevention of hypertrophic PWS,” the researchers concluded. “Diffuse thickening and nodules should be distinguished, as a different age of onset may indicate different pathomechanisms.”
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