Fire mark

definition

A fire mark, too Naevus flammeus called, is a benign change in the skin that turns dark red to reddish purple in color. The fire mark also owes the widespread name "port wine stain" to its appearance.
This congenital malformation of the smallest vessels, so-called capillaries, is one of the rare malformations and can occur both alone and as a partial symptom of a higher-level disease. Important examples of such diseases are the Sturge-Weber syndrome or the Klippel-Trénaunay syndrome.

causes

Fire marks arise due to a Malformation of the finest blood vesselsknown as capillaries. This Blood vessels are dilated and lead to the typical reddish-purple appearance of the fire mark. So it is not, as is often assumed, a pigment disorder.

The fire mark is mostly innate or arises immediately after the birth. Why some people are affected by a fire mark and others are not has not been conclusively clarified.However, there are genetic causes and specifics in the DNA of many people with a fire mark. But these variants have no disease value and are not worrying.

A fire mark is rarely part of a symptom complex that is based on an illness. Also in this case are genetic changes verifiable. Such a disease is that Sturge Weber Syndrome, the cause of which is largely unclear. Spontaneous mutations in the DNA of those affected are often assumed, and familial variants of the disease are rarely known. Another cause of a fire mark is that Klippel-Trénaunay syndrome. This congenital disease is associated with multiple vascular malformations and growth disorders. The cause of the Klippel-Trénaunay syndrome also lies in DNA mutations.

There is a common one Misbelief about that Mothers through their behavior could affect the occurrence of fire marks in your child. That's not the case. Neither wearing tight clothing, nor taking medication or using forceps, can lead to a fire mark in the child. This misconception leads to unfounded guilt feelings in many mothers.

diagnosis

First considered the doctor pinpointed the stain and arranges him according to his appearance according to a likely diagnosis too. The fire mark as such already has a characteristic appearance.

With a Glass spatula he presses the mark and can do it like that differ from hemorrhage. When you press it, the enlarged vessels of the fire mark empty and it looks skin-colored. Further examinations of the skin like one Sampling or the like are not necessary.

A Differentiation from blood sponges (hemangioma) can already be done by the appearance. While hemangiomas can resemble a fire mark in the first few days of life, they change over the weeks. This change falls through the regular examinations Pediatrician on.

Should be great fire mark near the eyes will occur a MRI of the skull performed as well as a Examination of the eyes. Furthermore, if a syndrome is suspected, for example Sturge-Weber syndrome, special further diagnostics are initiated. Here, too, an MRI of the skull and a special examination of the eyes are necessary, since malformations in the eyes and brain are common. Apart from vascular malformations include epileptic seizures to the other symptoms of Sturge-Weber syndrome. These are analyzed in more detail using an EEG.

Concomitant symptoms

The fire mark occurs in most cases without accompanying symptoms on. It hurts and does not itch. Besides, it leads not to impairments in the affected child.

In the size fire marks can vary greatly, so that the size can vary from a few millimeters to several centimeters.
Concomitant symptoms only occur when the fire mark is as Part of a symptom complex occurs when a syndrome occurs. In the case of Sturge-Weber syndrome, possible accompanying symptoms are impaired vision, epileptic seizures and consequential damage in the case of seizures that are difficult to treat. Such consequential damage can be impairment of mental abilities.

The Klippel-Trénaunay syndrome is associated with pronounced malformations of the vessels. In addition, there is usually a one-sided giant stature, less often a short stature. The difference in length of the legs usually causes problems when walking.

When do you have to remove it?

In principle there must be a fire mark not removed become. It is about a benign vascular changethat is not a health problem. Therefore, removal is never a “must”. However, for many children, at the latest when they enter kindergarten, fire marks can become one great emotional stress become.
Large fire marks on the face are usually a problem for those affected significant cosmetic problem. In the end, it is an individual decision whether to have a fire mark removed from you or your child. However, one should think about the child's interests and future development, especially if there are stains in particularly exposed areas such as the face.
However, there is no medical indication for removal.

forecast

The Fire mark can over time in his Change appearance and both darker as well as brighter become. Usually it disappears However not by itself and, unlike the stork bite, remains in most cases. The fire mark as such does not pose a health risk.

It is benign and has no malignancy potential. This means it cannot develop into a malignant disease. However, over time, very large stains, especially on the face, can become one large emotional stress for children. Teasing, marginalization or bullying can follow secondary, even if this is unjustified. This can restrict the child's educational and, in particular, personal development. In rare cases, the stain may reappear after removal.

Different locations

Fire mark on the face

In approximately 80% of the cases are fire marks in the face localized. The congenital malformation, which appears as a reddish spot of different sizes, is usually located off the center line of the face. Possible locations are, for example End faces or Cheeks. An asymmetrical distribution pattern is typical.

The Fire mark grows with the Growth of the child With. The size can vary widely - everything is possible from a few millimeters to several centimeters in diameter. In very rare cases, stains on the face are part of a symptom complex in the context of a higher-level disease, such as Sturge-Weber syndrome.

Hence, in certain cases further investigations necessary for clarification. In the vast majority of cases, however, the stains on the face are harmless. Very large stains around the eyes require one ophthalmological control, since possibly deeper vessels in this area are affected by malformations. Fire marks on the face are mostly used within the first few years of life Laser therapy removed as they can become a cosmetic problem for those affected.

Fire mark on the neck

Of the neck is a rather unusual place for a fire mark. In principle, fire marks can spread over the entire body, but the neck is no typical localization.
Often, however, fire marks are marked with the so-called Naevus flammeus simplex, the Stork bite, mistaken. This is also known under the name Unna-Politzer-Naevus. Unlike other fire marks, however, stork bites usually disappear by the first year of life. They occur in up to 60% of newborns and are harmless.

Read more about the topic here: Stork bite on baby

On the forehead

Fire marks can also be located on the forehead. Basically, fire marks are not restricted to a specific body region. They can appear anywhere on the body. The forehead is also a possible location. Fire marks on the forehead are mostly to the side and show an asymmetrical distribution pattern. They are often easily mistaken for so-called stork bites of the forehead. However, these are more in the middle of the forehead.

At the back of the head

Fire marks are rarely found on the back of the head. About 80% of the fire marks are localized on the face. However, since fire marks can appear anywhere on the body, the back of the head is also a possible location. Fire marks on the back of the head are usually not a restriction for those affected, as they are covered by hair anyway. If necessary, however, they can also be removed using laser therapy.

Therapy of a fire mark

Whether you have a fire mark treated or not is ultimately up to you. In this sense, there is no medical necessity, since the fire mark is a benign malformation. Often times, parents have to decide whether or not to have the fire mark removed from their baby.

Laser therapy

A common method of removing fire marks is laser therapy. As a rule, a fire mark is subjected to laser therapy in the first days of life up to the 6th month of life. If parents have not yet made a decision about the therapy at this time, laser therapy is usually carried out again at school age, as children can then actively participate in the decision. The therapy is carried out with a pulsed dye laser. In some cases, other lasers (alexandrite lasers and Nd: YAG lasers) that penetrate deeper into the skin are used. This is especially useful for thicker and darker stains. The laser causes the red blood cells in the enlarged vessels of the fire stew to be heated. These red blood cells give off heat to the vessel walls, which then burst. Therefore, the skin is discolored blue immediately after the treatment. This discoloration (hematoma) disappears after 1 to 2 weeks. Usually 8 to 10 treatments are necessary to achieve a satisfactory result. Less or more sessions may also be necessary. The interval between two therapy sessions is an average of 2 months. A slight swelling may occur after the treatment, which will decrease with cooling. After the therapy, major physical exertion and sport as well as saunas should be avoided for about 3 days. Direct sunlight should be avoided for 2 to 3 weeks. Many doctors advocate completing treatment before the age of three in order to avoid stigmatizing the child. Infants and toddlers are given general anesthesia for the treatment, as it is painful and otherwise not tolerated.

Other options of therapy

Aside from laser therapy, there is another inexpensive and non-invasive way to treat the stain, which is makeup. Special camouflage make-up that has a high degree of coverage is required to cover a fire mark. Although the fire mark cannot be removed this way, it can be made “invisible”, so to speak. Depending on how big the fire stain is and where it is, a cover can be a good alternative to laser therapy. In particular, small, inconspicuous fire marks that are bright can be covered very well. In all fairness, however, it must be said that covering very large and dark stains is very difficult. In the face in particular, the cosmetic result with make-up is not particularly satisfactory for many people. For large fire marks or fire marks on the face, laser therapy is usually the better alternative. Unfortunately, there is no other treatment option.

Fire marks on the baby

Since fire marks are congenital malformations of the smallest vessels, they are already visible immediately after birth. It is a benign malformation that is neither harmful to the baby nor bothersome. Fire stains do not cause pain or discomfort. About 80% of the fire marks are localized on the face. They can be associated with syndromes such as Sturge-Weber syndrome and therefore usually require further diagnosis in the baby. Such syndromes, however, are downright rarities. Very large stains in the area of ​​the eyes require an ophthalmological check, since deeper vessels in this area can also be affected by malformations. In the vast majority of cases, fire marks are harmless. However, they tend to get darker over the course of life, so they are usually removed as early as infancy and toddler age. Although they do not directly endanger the child's physical health, they can have significant psyche consequences. Especially in kindergarten age, large marks on the face can stigmatize children and lead to exclusion by others. It is therefore advisable to remove very large marks from the face.

Beta blockers against a fire mark

Beta blockers belong not for therapy of the fire mark!

However, they become the Treatment of so-called hemangiomas used. These are often confused with fire marks in the population. Are hemangiomas Vascular growthswhich, in their initial stages, can resemble fire painting. However, they can within a few days or weeks Growth in thickness and size through so they raised above the skin level and well palpable are. So they can be easily distinguished from fire marks.

Spiritual meaning

It exists different, sometimes different, views on the spiritual meaning of fire marks. Mostly they are called a kind Leftovers from a previous life viewed. Opinions on the significance of this earlier life, however, differ greatly. Part of them will be one negative meaning promised. So one often finds an association with bad deeds in the past life or even witchcraft.

However, another superstition sees the fire mark simply as a kind Remnants of a significant experience. The fire mark is often referred to as a symbolic remnant of contact with other people in previous life. The extent to which this contact took place is not specified.