Rare Case of Pediatric Lower Limb Verrucous Venous Malformation: Treatment Approach and Considerations.

BACKGROUND

Verrucous venous malformation (VVM) is a rare, congenital, low-flow vascular anomaly composed of capillaries and veins in the dermis and subcutaneous tissues. Diagnosis is difficult because knowledge of cases is rare and typically identified with sonographic imaging and elevated GLUT-1. Treatment is mired by high rates of recurrence and residual pain, with further enlargement upon resection or injury. Current management strategies include a combination of laser therapy, surgery, cryotherapy, and topical steroids, each with varying rates of success.

METHODS

The authors examine a case of confirmed VVM, which was initially treated with a candela pulsed dye laser and propranolol to no avail. A combination of surgical approaches were chosen.

CONCLUSIONS

We now look to topical sirolimus 1% as an adjunct for this patient with residual lesions. Questions remain as to the effectiveness, optimal dose, and duration of topical sirolimus and whether this combination of surgical and topical intervention will be effective in the treatment for VVM.