Surgical Ligation of Dilated External Carotid Artery Improves Associated Port-wine Stain

To the Editor.—  Port-wine stains are a congenital purplish discoloration of the skin on the face and neck, usually occurring unilaterally, and caused by the presence of multiple abnormal superficial blood vessels.¹ Usually they darken with age, but sometimes may fade partially over the years.² They are occasionally associated with underlying vascular abnormalities. Treatment is normally focused on the lesion itself, either surgically by excision and closure, or nonsurgically by tattooing³ or laser.^1,4We describe an unusual presentation and treatment of port-wine stains present since birth in a 14-year-old girl. After being quiescent for 12 years, the stain began to darken progressively, with concomitant enlargement and discomfort of the left ear, some interference with vision in the left eye, systolic bruit in the neck, and pathologic enlargement of the left external carotid artery. Treatment of the associated deeper vascular abnormality also lead to improvement of the