Delineating capillary malformations in the operating suite using white eyeliner pencil.

摘要

We concur completely with the helpful tip regarding preoperative outlining of capillary malformations (CM) with a white marker (1). In addition to the stated benefits, such as parental tracing to better target treatment, aid in more accurate measurement and therefore billing, less laser interaction than with permanent marker, and easy postoperative removal, we would add several additional points. First, the authors comment that such border highlighting can help distinguish CM from reactive erythema due to topical anesthesia in the office. Although true, it can also aid in the general anesthesia setting, where certain anesthetics, laser treatment to adjacent areas, or both can obscure CM borders. Second, when coupled with serial photography, this technique greatly enhances assessments of response to therapy. Finally, although I originally used white eyeliner pencil as well, my colleague Marilyn Liang, M.D., suggested a white gel marker instead (Gelly Roll medium, Sakura, Japan), and I have never gone back. The gel marker has a duller tip, minimizing discomfort when used in the awake child, and traces more easily on skin. In either case, this "Technique for Tots" is quite useful.