What Contributes to Limb Differences in Children with Capillary Malformations?

Capillary malformations (CM) occur in a small percentage of children, and can be complicated by lymphatic, venous, arteriovenous anomalies, such as birthmarks and port wine stains, and/or soft-tissue or bone overgrowth that may result in differences in limb length. Complications might be present at birth or occur years later.

Using data from a multicenter cohort study of children with CM, a recent study aimed to identify factors associated with leg length discrepancy (LLD) and to identify factors associated with venous and lymphatic complications associated with CMs. The study enrolled just under 100 patients with CM; in this cohort, 15% had LLD, 33% had venous anomalies, and 14% had lymphatic malformations.

The results showed that LLD was significantly associated with a greater than 15-mm discrepancy in the circumference of limbs above the knee, and a difference in arterial blood flow between the two limbs that was greater than or equal to 50%. Geographic-type CMs were associated with lymphatic anomalies. The study did not find any clinical or hemodynamic factors, except for older age, associated with venous anomalies.

The authors note that measuring arterial blood flow is simple, noninvasive and low cost. Using this measurement could be a helpful tool to detect LLDs.