Skin ulcerations as manifestation of vasculopathy in neurofibromatosis

Neurovascular Stains in Two Girls with Neurofibromatosis 1

We report two girls, ages 9 and 17 years, with a clinical diagnosis of neurofibromatosis 1 (NF-1) who presented with ill-defined, blanchable, erythematous patches on the dorsal feet and ankles. We hypothesized that these patches were a rare cutaneous finding in NF-1 that exist on a clinical and histopathologic spectrum with previously described NF-1 vascular lesions including blue-red macules and skin ulceration due to NF-1 vasculopathy. We suggest that these lesions be called neurovascular stains (NVSs) to unify their clinical and histopathologic features.

Poor wound healing after pial synangiosis in 2 children with moyamoya vasculopathy associated with neurofibromatosis type 1

Wound healing is a key component of recovery for children with neurologic conditions undergoing neurosurgical procedures. Understanding factors that can impair wound healing aids in planning long-term clinical care. Children with neurofibromatosis type 1 are at risk for vasculopathies in the brain (including moyamoya vasculopathy) and in other organs, including the heart, lung, and skin. Neurofibromatosis 1 is caused by mutations in the gene for neurofibromin, a protein that plays a role in tissue maintenance and repair as well as tumor suppression. The authors report 2 children with neurofibromatosis 1-associated moyamoya vasculopathy who developed significant wound healing complications after pial synangiosis surgery. They discuss possible contributors to these complications, including the role of neurofibromin and the possibility of vasculopathy affecting the skin, and the implications of poor wound healing in pediatric neurology patients.