A new approach to the management of caliber-persistent artery: A case report and analysis of previously reported cases

• Published in: International journal of dermatology 2016-01, Vol.55 (1), p.11-16
• Main Authors: Agha-Hosseini, Farzaneh, Sheykhbahaei, Nafiseh
• Format: Article
• Language: English
• Subjects: Adult; Arteries - abnormalities; Biopsy, Needle; Cheilitis - diagnosis; Cheilitis - etiology; Follow-Up Studies; Glucocorticoids - administration & dosage; Humans; Immunohistochemistry; Injections, Intralesional; Lip - blood supply; Lip - drug effects; Male; Severity of Illness Index; Treatment Outcome; Triamcinolone - administration & dosage; Vascular Malformations - complications; Vascular Malformations - pathology
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/ijd.13039

Summary A caliber‐persistent labial artery (CPLA) is an incipient arterial branch that penetrates near the submucosal tissue of the lip without dividing or reducing in diameter and often appears as a palpable lesion on the lip. It occurs at an incidence of approximately 3%. This study investigated the causes of swelling of the lips, focusing on CPLA, and reviewed the literature for past cases in order to inform the treatment of a 32‐year‐old man presenting with an asymptomatic, solitary, elevated lesion on the vermilion of the upper lip of seven months duration. Biopsy resulted in abundant bleeding. Histopathology showed fragments of connective tissue composed of spindle‐shaped cells, fibroblasts, collagen fibers and sections of small blood vessels with lymphocytic infiltration of chronic inflammatory cells around the small vessels. A thick‐walled section reminiscent of a major artery was apparent. In view of the size of the lesion and concern over the functional and esthetic impairment that might result from surgery, the patient was treated with triamcinolone (40 mg/ml) injected at low pressure into the lesion, which caused the formation of deposits of colloidal particles within the lesion. The procedure was repeated twice at 2‐week intervals. Subsequently, the lesion was found to have completely regressed. The favorable therapeutic results achieved, and the findings of the present review, support the intralesional injection of triamcinolone as a first‐line conservative treatment in CPLA rather than a surgical approach that can result in inordinate hemorrhaging.