An interprofessional approach should be used for the medical management of DCMO patients. Small CMs are typically benign and require no treatment. Large CMs should be treated due to aesthetic reasons and societal exclusion, as they have a higher tendency to hypertrophy. Pulse-dye laser photocoagulation should be used for large CM. Therapy should be initiated before the age of 6 months. Laser treatments typically have greater efficacy for CMs on face than non-facial areas such as distal extremities. Potential explanations for reduced efficacy in extremities include greater lesion size and deeper location of vessels due to thicker epidermis. Patients may be less inclined to pursue treatments for non-facial lesions due to lesser visibility and financial burden of multiple laser treatment sessions necessary for visible improvement. As DCMO frequently involves trunk and lower extremities, more studies are needed to improve laser treatment in non-facial areas and identify barriers to treatment. Surgery is the last resort for non-responding hypertrophied CM. However, redarkening after laser treatment and recurrence of<unk>  after surgical excision are common. Differences in leg length observed in DCMO can lead to problems with gait, joint pain and scoliosis. An orthopedic consultation should be made for patients with<unk>  involving bone. In Parkes-Weber syndrome, leg discrepancies > 2cm require orthopedic evaluation. Similar recommendations can be assumed for the limb<unk>  in DCMO. Orthodontic evaluation can be made in presence of facial hypertrophy. DCMO patients do not typically present with lymphatic<unk> s, therefore MRI studies or lymphangiography are not necessary. MRI is indicated if there is presence of lymphatic vessels, edema, or large veins. Similarly, AVMs are not present with DCMO, thus ultrasound/Doppler or arteriographies are not required. Patients with DCMO have not been reported to have developmental or neurological abnormalities, thus neuroimaging is not necessary. However, head circumference and neurologic development should be serially examined. Presence of neurological abnormality or macrocephaly can suggest macrocephaly-capillary<unk>  syndrome. Hemihypertrophy-multiple lipomatosis or Beckwith-Wiedemann syndrome are diseases with total hypertrophy and are associated with an increased risk of Wilms tumor. About 10% of DCMO cases present with total hemihypertrophy. Because of this, screening of Wilms tumor is recommended in DCMO patients with total hemihypertrophy. However, vascular anomaly and soft tissue hypertrophy in the absence of hemihypertrophy have a low risk of Wilms Tumor.
Diffuse capillary malformation with overgrowth
Hyperkeratotic cutaneous capillary-venous malformation
Benign neonatal hemangiomatosis
Arteriovenous malformation
Diffuse neonatal hemangiomatosis
Cavernous venous malformation
Fibrillary astrocytoma
Infantile hemangiopericytoma