Utility of Intralesional Sclerotherapy with 3% Sodium Tetradecyl Sulphate in Cutaneous Vascular Malformations

Abstract

Vascular malformations have devastating cosmetic effects in addition to being associated with pain and bleeding. Sclerotherapy has been successfully used in treating complicated hemangiomas and vascular malformations. To assess the efficacy of sclerotherapy with 3% sodium tetradecyl sulphate (STS) in venous and lymphatic malformations. We performed sclerotherapy with 3% STS in 13 patients with venous malformations and microcystic lymphatic malformation, all low-flow malformations and with extent predominantly to the subcutis, confirmed using Doppler ultrasound. Lesions were located on the face, lower lip, flanks, buttocks, and extremities. Patients presented for cosmetic reasons, pain, or bleeding. Sclerotherapy was undertaken as an office procedure without any radiological guidance and therapy repeated every 3 weeks. Therapeutic efficacy was assessed subjectively clinically and photographically. The lesions regressed by 90% to 100% in 11 cases after a mean of four injections, with no improvement in two cases (one each of venous malformation and lymphatic malformation). Complications included cutaneous blister formation, erosions, and crusting at injection site in seven cases and atrophic scarring in four patients. Sclerotherapy with 3% STS is a simple, safe, and effective modality for venous malformations and can be undertaken as an office procedure in lesions limited to the subcutis.