Some Therapeutic Recommendations Are not up to Date

It is to be welcomed that even rare vascular malformations are explored in Deutsches Ärzteblatt (1). The case description of a glomuvenous malformation is well-structured in the diagnostic analysis. The histologic/ molecular-genetic explanations are concise and informative. But the described therapeutic recommendations, such as excision, argon, or CO₂ laser are neither up to date nor guideline-conform in superficial cutaneous malformations. These measures are either ineffective or, furthermore, bear a high risk of scar formation. For superficial venous malformations, such as described in the case under discussion, modern laser procedures, such as long pulsed Nd:YAG laser (1064 nm) have proved to be effective (2). Intense pulsed light technology (IPL) can also be used effectively and is gentle on the skin, depending on wavelength and skin type (3).

For deeper-seated malformations, minimally invasive interventional radiologic methods should be considered, for example catheter embolization or percutaneous sclerotherapy. If required this can be combined with laser or IPL technology. Such an approach provides a controlled, minimally invasive therapeutic option with lasting long-term effects.