Newcomers in Vascular Anomalies

Two Cases of FAVA With an Uncommon Localization in Adults

ABSTRACT

The fibroadipose vascular anomaly (FAVA) is a relatively unknown vascular anomaly in the realm of adult dermatopathology. Despite its intramuscular location, dermatologists often encounter cases, approaching them surgically under the presumption of a potential lipoma. This entity was first described in 2014, and consequently, many FAVA cases may be concealed in our archives under diagnoses of other entities that require differential diagnoses, such as intramuscular fast-flow vascular anomaly. Clinically, these anomalies typically manifest preferably in young women or girls and predominantly in the extremities. In this article, we present 2 cases of FAVA with atypical clinical features in terms of their topography and age at onset. However, histopathologically, they exhibit typical characteristics with fibroadipose tissue and dysmorphic venous vessels dissecting the affected striated muscle.

Validation of measurement scores for evaluating vascular anomaly skin lesions

Vascular anomalies comprise a heterogeneous group of disorders caused by abnormal proliferation or development of vascular and/or lymphatic vessels. Vascular anomalies present with various symptoms and complications, but no standardized methods evaluate their severity, and to measure treatment outcomes is difficult. To assess the responsiveness of measurement scores for evaluating vascular anomaly skin lesions, we conducted a validation study to compare these measurement scores with patients’ objective data. In this study, data were collected from treated and untreated patients. Skin lesions were photographed at baseline and after a follow‐up period of 3–6 months. The volume of skin lesions, the degree of red or purple coloration, and color tone were measured objectively. Two external dermatologists evaluated patients’ photographs and determined scores, which represented criteria for improvements in skin lesions (size and color) and 6‐point Physician Global Assessment scores. The correlation between these scores and patients’ objective data (lesion volume and color) was assessed to validate the scores. Twenty‐three cases of vascular anomaly (seven vascular tumors, five lymphatic malformations, three venous malformations, and eight lymphatic–venous malformations) were examined. Scores for improvements in vascular anomaly skin lesions (size and color) correlated with a change in lesion volume, the degree of red or purple coloration, color tone score, and 6‐point Physician Global Assessment score. Our findings suggest that these measurement scores are responsive to changes in vascular anomaly skin lesions after observation.