Q: My three-year-old grandson has a purple birthmark on his face, what is called a port wine stain. A friend told me that he could get seizures later in life. Is this true?
A: Three out of every 1,000 children are born with this type of birthmark. A port wine stain is so named because of its purplish wine-like colour. It is caused by an abnormal growth in the tiny blood vessels or capillaries located in the skin.
Although these marks may be anywhere in the body, they have a bad habit of being on the face where they are unsightly. Some can be quite large and cover as much as half of the facial area.
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Of all the children with such birthmarks, only eight percent will develop what is known as Sturge Weber syndrome. This means that the abnormality of the blood vessels extends farther than just the skin, and can involve internal organs such as the brain. In these cases there is a possibility of epileptic seizures because the affected brain cells can generate abnormal electrical activity. It is thought that there is a greater chance of Sturge Weber syndrome if the port wine mark is located in the upper area of the face, above the eyes, or in the scalp region. However there is still a slight chance of this even if the mark is in another part of the face.
Seizures can be treated with medications. However, even without seizures your grandchild could develop psychological problems with low self-esteem due to his appearance, so treatment options should be explored. A young child will not be aware of his or her appearance, but other children can be cruel and might bully or tease. Psychotherapy may be required.
Concealing make-up is the easiest solution. Some types of make-up are available on prescription. Hospital burn departments can be helpful with ways of concealing blemishes.
Laser therapy is also an option. A laser beam is used to destroy the abnormal blood vessels while leaving the overlying tissue and skin surface unscarred.
Psychopath clarification
I want to respond to the Oct. 9 letter to the editor regarding personality disorder and my giving a suggestion to avoid such people if possible. I was referring to those individuals with antisocial personality disorders, also called psychopaths, although this term is not used as frequently nowadays.
I am not prejudiced against the mentally ill. In fact I am a British-trained psychiatrist and a member of the Royal College of Psychiatrists. I have also served on various mental health committees in the community working for the betterment of the mentally ill.
Of course, people with genuine depression should not be avoided, but some psychopathic individuals sometimes use depressive symptoms to gain sympathy and further their own ends, emotional or financial. Yes, they do sometimes commit suicide.
I reiterate that it is better to avoid getting into a relationship with such people, as there is no known treatment available for them at this time.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
