We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

The Hidden Face of Venous Malformations A Multidisciplinary Therapeutic Approach

Pedro Redondo, MD
Arch Dermatol. 2008;144(7):922-926. doi:10.1001/archderm.144.7.922.
Text Size: A A A
Published online


Venous malformations (VMs) are ectatic vessels that are morphologically and histologically similar to veins and have a low blood flow. The thin-walled vascular channels are composed of a deficient layer of smooth-muscle cells and are lined by quiescent endothelium. The TIE2 signaling pathway is critical for endothelial cell–smooth muscle cell communication in venous morphogenesis.1 Venous malformations represent approximately one-half to two-thirds of all vascular malformations, and the majority of them are sporadic anomalies. The skin or mucosa that covers VMs varies in color according to the depth and degree of ectasia of the lesion. More superficial malformations are purple and deeper ones are blue, green, or even imperceptible. The lesions are soft to the touch, can have a nodular appearance, and empty with compression. Highly ectatic vessels sometimes contain small venous thromboses, producing pain and inflammation. Phleboliths, which are used as radiological markers of this type of malformation, can be present from an early age.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Anticoagulant and antiangiogenic actions of heparins. Low-molecular-weight heparin (LMWH) binds to antithrombin and inhibits thrombin and factor Xa by different binding mechanisms. LMWH has been shown to inhibit vascular endothelial growth factor (VEGF)- and basic fibroblast growth factor (bFGF)-mediated angiogenesis in vivo, inhibiting the binding of these growth factors to their receptors. R indicates receptor.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Schematic representation of the relationship between fibrinolytic system and angiogenesis. Interactions among vascular endothelial growth factor (VEGF)-activated endothelial cells, local/distant fibrinolysis, and angiogenic stimulus. α2-AP indicates α2-antiplasmin; bFGF, basic fibroblast growth factor; ECM, extracellular matrix; FDP, fibrin degradation product; MMPs, matrix metalloproteinases; PAI-1, plasminogen activator inhibitor type 1; t-PA, tissue plasminogen activator; U-PA, urokinase plasminogen activator; and U-PAR, urokinase plasminogen activator receptor.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

12 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles