Partial re-emergence of a port-wine stain following successful treatment with flashlamp-pumped dye laser

We present a 49-year-old patient with a congenital superficial vascular malformation of port-wine stain (PWS) type which has partially re-emerged in the 2.5 years since it was almost completely obliterated with the flashlamp-pumped short pulse pulsed-dye laser (FPDL). This observation is discussed with respect to the possible pathogenesis of PWS, with particular reference to the underlying autonomic nerve supply. The latter would not be expected to respond to FPDL and may explain re-emergence of the lesion.