Therapeutics in Dermatology
A reference textbook in dermatology
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Superficial lymphatic cistic malformations (lymphangiomas)

23 May 2013, by MARUANI A. & LORETTE G.

Lymphatic malformations or lymphangiomas develop in the lymphatic system whilst the baby is in the womb and are present – although not always visible - at birth. They develop from the lymphatic system, which consists of a network of very fine diameter vessels which drain lymph into the lymph nodes.

Lymphatic malformations consist of small lymphatic pockets or cysts. Some are very small (microcystic malformations); some are larger (macrocystic malformations). They can be superficial or deep, isolated or combined with other malformations. They are most often located in the head and neck area.

Macrocystic lymphangiomas can sometimes be detected in utero during an ultrasound scan. They show up as a swelling under the skin. Masses compressing the airways require urgent treatment. The basic treatment consists in injecting sclerosing agents into the cysts (to "glue" the sides together) which can be followed by surgery. Cysts in the malformation may become infected, causing inflammation, swelling, redness, pain in the lymphangioma and fever. This requires treatment with anti-inflammatories and sometimes antibiotics. 

The microcystic forms present as small confluent blisters filled with clear or bloody fluid. They may bleed or become infected. These forms can be treated with laser therapy, surgery or sclerosis, but recurrence is common.

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