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Dani A, Price HN, Gildenstern V. Telangiectatic patches in a 10-year-old boy. Pediatr Dermatol 2024; 41:325-327. [PMID: 37822016 DOI: 10.1111/pde.15442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Advika Dani
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Harper N Price
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Vanessa Gildenstern
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
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2
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Dedania V, Blei F. Letter to the Editor regarding "Cutis marmorata telangiectatica congenita: Incidence of extracutaneous manifestations and a proposed clinical definition". Pediatr Dermatol 2024; 41:376. [PMID: 38494785 DOI: 10.1111/pde.15515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/16/2023] [Indexed: 03/19/2024]
Affiliation(s)
- Vaidehi Dedania
- Department of Ophthalmology, NYU Langone Medical Center, NYU Grossman School of Medicine, New York, New York, USA
| | - Francine Blei
- Department of Pediatrics/Vascular Anomalies Program, NYU Langone Medical Center, NYU Grossman School of Medicine, New York, New York, USA
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3
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Aromolo IF, Di Michele E, Boggio FL, Cattaneo A, Marzano AV. Telangiectatic Macules Spreading During More Than 30 Years: A Quiz. Acta Derm Venereol 2024; 104:adv18429. [PMID: 38270259 PMCID: PMC10831866 DOI: 10.2340/actadv.v104.18429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/08/2023] [Indexed: 01/26/2024] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
| | - Eleonora Di Michele
- Department of Pathophysiology and Transplantation, Milan University, Milan, Italy
| | | | - Angelo Cattaneo
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Department of Pathophysiology and Transplantation, Milan University, Milan, Italy; Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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4
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Cutrone M, Van Gysel D. Transient abdominal telangiectasia of the newborn: Four new cases with abdominal distension. Pediatr Dermatol 2024; 41:73-75. [PMID: 37258091 DOI: 10.1111/pde.15351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/29/2023] [Indexed: 06/02/2023]
Abstract
Transient abdominal telangiectasia of the newborn (TATN) is a recently described entity. The majority of cases had no specific clinical context or trigger identified, but a minority occurred in the clinical context of transient increased intraabdominal pressure. We report four additional cases of TATN, all in the presence of transient abdominal distension, further supporting the causative relationship of abdominal distension to TATN.
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Affiliation(s)
- Mario Cutrone
- Pediatric Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Dirk Van Gysel
- Department of Pediatrics, O.L.Vrouw Hospital Aalst, Aalst, Belgium
- Interdisciplinary Unit of Pediatric Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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5
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Flor D, Xará J, Martins F, Coutinho I, Cardoso JC. Acquired diffuse telangiectasias with an unequivocal immunohistochemistry. Clin Exp Dermatol 2023; 49:102-104. [PMID: 37706513 DOI: 10.1093/ced/llad321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
A 56-year-old woman presented with abdominal, lumbar and thoracic livedo with 2 years of evolution, consisting of violaceous poikilodermatous patches with scattered petechiae on a base of erythema and telangiectasia, accompanied by diffuse and mild skin atrophy. Histological analysis revealed vasodilation of the superficial dermis and thickening of capillary walls, highlighted by periodic acid–Schiff stain and immunohistochemistry for collagen type IV.
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Affiliation(s)
- Duarte Flor
- Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Joana Xará
- Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Francisco Martins
- Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Inês Coutinho
- Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - José C Cardoso
- Dermatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
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6
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Dib N, Isnard C, Mouthon L, Dupin N. Genital and Perigenital "W"-Shaped Telangiectasias in Women With Limited Cutaneous Systemic Sclerosis. JAMA Dermatol 2023; 159:1279-1281. [PMID: 37755867 DOI: 10.1001/jamadermatol.2023.3335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
This case report describes 3 patients with limited cutaneous systemic sclerosis who were found to have telangiectasias affecting the vulva and the inguinal folds.
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Affiliation(s)
- Nicole Dib
- Department of Dermatology, AP-HP, Cochin Hospital, Paris, France
| | - Camille Isnard
- Department of Dermatology, AP-HP, Cochin Hospital, Paris, France
| | - Luc Mouthon
- Department of Internal Medicine, AP-HP, Cochin Hospital, Paris, France
| | - Nicolas Dupin
- Department of Dermatology, AP-HP, Cochin Hospital, Paris, France
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Hägerling R, Van Zanten M, Behncke RY, Ulferts S, Hansmeier NR, Märkl B, Witzel C, Ho B, Keeley V, Riches K, Mansour S, Gordon K, Ostergaard P, Mortimer PS. Erythematous capillary-lymphatic malformations mimicking blood vascular anomalies. JCI Insight 2023; 8:e172179. [PMID: 37698920 PMCID: PMC10619487 DOI: 10.1172/jci.insight.172179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/06/2023] [Indexed: 09/14/2023] Open
Abstract
Superficial erythematous cutaneous vascular malformations are assumed to be blood vascular in origin, but cutaneous lymphatic malformations can contain blood and appear red. Management may be different and so an accurate diagnosis is important. Cutaneous malformations were investigated through 2D histology and 3D whole-mount histology. Two lesions were clinically considered as port-wine birthmarks and another 3 lesions as erythematous telangiectasias. The aims were (i) to demonstrate that cutaneous erythematous malformations including telangiectasia can represent a lymphatic phenotype, (ii) to determine if lesions represent expanded but otherwise normal or malformed lymphatics, and (iii) to determine if the presence of erythrocytes explained the red color. Microscopy revealed all lesions as lymphatic structures. Port-wine birthmarks proved to be cystic lesions, with nonuniform lymphatic marker expression and a disconnected lymphatic network suggesting a lymphatic malformation. Erythematous telangiectasias represented expanded but nonmalformed lymphatics. Blood within lymphatics appeared to explain the color. Blood-lymphatic shunts could be detected in the erythematous telangiectasia. In conclusion, erythematous cutaneous capillary lesions may be lymphatic in origin but clinically indistinguishable from blood vascular malformations. Biopsy is advised for correct phenotyping and management. Erythrocytes are the likely explanation for color accessing lymphatics through lympho-venous shunts.
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Affiliation(s)
- René Hägerling
- Institute of Medical and Human Genetics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Berlin, Germany
- Research Group Development and Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Malou Van Zanten
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
- Dermatology and Lymphovascular Medicine, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Rose Yinghan Behncke
- Institute of Medical and Human Genetics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
| | - Sascha Ulferts
- Institute of Medical and Human Genetics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
| | - Nils R. Hansmeier
- Institute of Medical and Human Genetics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Berlin, Germany
- Research Group Development and Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Bruno Märkl
- Institute of Pathology and Molecular Diagnostics, University Clinic Augsburg, Augsburg, Germany
| | - Christian Witzel
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernard Ho
- Dermatology and Lymphovascular Medicine, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Vaughan Keeley
- Lymphoedema Clinic, Derby Hospitals Foundation NHS Trust, Derby, United Kingdom
| | - Katie Riches
- Lymphoedema Clinic, Derby Hospitals Foundation NHS Trust, Derby, United Kingdom
| | - Sahar Mansour
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
- SW Thames Regional Centre for Genomics, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Kristiana Gordon
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
- Dermatology and Lymphovascular Medicine, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Pia Ostergaard
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Peter S. Mortimer
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
- Dermatology and Lymphovascular Medicine, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
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8
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Nunes Rosado FG, Lekovic D, Gagan J, Malter J, Chen W, Sykes DB. Comprehensive Next-Generation Sequencing Testing in a Patient with TEMPI Syndrome. Lab Med 2023; 54:546-549. [PMID: 36864546 DOI: 10.1093/labmed/lmad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
TEMPI syndrome is a new and poorly understood disease that is currently considered a type of plasma cell neoplasm with paraneoplastic manifestations. The TEMPI acronym defines the hallmarks of the syndrome: T for telangiectasia; E for erythrocytosis with elevated erythropoietin; M, monoclonal gammopathy; P, perinephric collections; and I, intrapulmonary shunting. Due to the marked erythrocytosis as the most common presenting feature, TEMPI is often misdiagnosed as polycythemia vera. However, unlike polycythemia vera, TEMPI is not associated with a JAK2 mutation. The pathogenesis of TEMPI syndrome is unknown, although a few hypothetical disease mechanisms have been previously discussed. Here we present a new case of TEMPI syndrome, discuss results of a next-generation sequencing (NGS) panel covering 1,425 known cancer-related genes, and review the current literature with focus on an update of the genetics of TEMPI syndrome. This is the first report of TEMPI that includes results of comprehensive NGS testing.
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Affiliation(s)
| | - Danijela Lekovic
- Clinic of Hematology, University Clinical Center Serbia, Belgrade, Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Jeffrey Gagan
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Malter
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Weina Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David B Sykes
- Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
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9
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Erol VB, Mutlu YG, Balik B, Mert A, Mergen S, Mergen M, Serin I, Cakir A, Ozden F, Sevindik OG. Intravascular B-cell lymphoma with generalized telangiectasias. J Dtsch Dermatol Ges 2023; 21:1025-1027. [PMID: 37401140 DOI: 10.1111/ddg.15148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/10/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Vedat Bugra Erol
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Yaşa Gul Mutlu
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Berrin Balik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Sena Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Aslı Cakir
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Ozden
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
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10
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Chandel A, Vidhate T, Chauhan V. Cutis marmorata telangiectatica congenita in a newborn: A differential diagnosis. Pediatr Neonatol 2023; 64:607-608. [PMID: 36964050 DOI: 10.1016/j.pedneo.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 03/26/2023] Open
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11
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López Riquelme I, Martínez García S. Unilateral Nevoid Telangiectasia in Pregnancy. J Cutan Med Surg 2023; 27:420. [PMID: 37067222 DOI: 10.1177/12034754231168841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Affiliation(s)
- Irene López Riquelme
- Dermatology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
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12
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Bertanha M, Mellucci Filho PL, Genka CA, de Camargo PAB, Grillo VTRDS, Sertório ND, Rodrigues LDS, Sobreira ML, Lourenção PLTDA. Quantitative analysis validation for sclerotherapy treatment of lower limb telangiectasias. J Vasc Surg Venous Lymphat Disord 2023; 11:708-715. [PMID: 37030450 DOI: 10.1016/j.jvsv.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND The evaluation of sclerotherapy efficacy for lower limb telangiectasias, which is the standard treatment for such condition, is commonly assisted by scores based on before and after pictures. This method is marked by its subjectivity, which impairs the precision of studies on the subject, making it unfeasible to evaluate and compare different interventions. We hypothesize that a quantitative method for evaluating the effectiveness of sclerotherapy for lower limb telangiectasias may present more reproducible results. Reliable measurement methods and new technologies may become part of the clinical practice in the near future. METHODS Before and after treatment photographs were analyzed using a quantitative method and compared with a validated qualitative method based on improvement scores. Reliability analysis of the methods was performed, applying the intraclass correlation coefficient (ICC) and kappa coefficient with quadratic weights (Fleiss Cohen), for analysis of inter-examiner and intra-examiner agreement in both evaluation methods. Convergent validity was evaluated by applying the Spearman test. To assess the applicability of the quantitative scale, the Mann-Whitney test was used. RESULTS A better agreement between examiners is shown for the quantitative scale, with a mean kappa of .3986 (.251-.511) for qualitative analysis and a mean kappa of .788 (.655-.918) for quantitative analysis (P < .001 for all examiners). Convergent validity was achieved by correlation coefficients of .572 to .905 (P < .001). The quantitative scale results obtained between the specialists with different degrees of experience did not show statistical difference (seniors: 0.71 [-0.48/1.00] × juniors: 0.73 [-0.34/1.00]; P = .221). CONCLUSIONS Convergent validity between both analyses has been achieved, but quantitative analysis has been shown to be more reliable and can be applied by professionals of any degree of experience. The validation of quantitative analysis is a major milestone for the development of new technology and automated, reliable, applications.
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Affiliation(s)
- Matheus Bertanha
- Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil.
| | | | - Caroline Araujo Genka
- Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | | | | | - Nathalia Dias Sertório
- Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Lenize da Silva Rodrigues
- Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Marcone Lima Sobreira
- Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
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Herron ED, Weir SA, Herron MD, Kole LCS. Annular Plaques Overlying Hyperpigmented Telangiectatic Patches on the Neck. Cutis 2023; 111:65-79. [PMID: 37075176 DOI: 10.12788/cutis.0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Elliott D Herron
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
| | - Sydney A Weir
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
| | - Mark D Herron
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
| | - Lauren C S Kole
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
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14
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Vollmer AS, Bertlich I, Haenssle HA. [Solitary reddish-blue nodule with telangiectasia on the face]. Dermatologie (Heidelb) 2022; 74:1000-1002. [PMID: 37704900 DOI: 10.1007/s00105-023-05227-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Anastasia S Vollmer
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland.
| | - Ines Bertlich
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland
| | - Holger A Haenssle
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland
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15
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Rosignoli L, Wood EH, Geloneck MM, Diaz LZ, Levy ML, Harper CA. Ocular Melanocytosis and Peripheral Retinal Avascularity in a Case of Cutis Marmorata Telangiectatica Congenita. Ophthalmic Surg Lasers Imaging Retina 2022; 53:647. [PMID: 36378608 DOI: 10.3928/23258160-20221011-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Bosma AL, Van der Zwaan D. [Abdominal telangiectasias in a newborn]. Ned Tijdschr Geneeskd 2022; 166:D6960. [PMID: 36300458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
We describe the case of a 3-week-old boy showing telangiectasias on the abdominal skin since 2 weeks. His medical (family) history and an abdominal echo showed no abnormalities. The diagnosis Transient Abdominal Telangiectasia of the Newborn was made.
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Affiliation(s)
- Angela L Bosma
- Amsterdam UMC, locatie AMC, afd. Dermatologie, Amsterdam (tevens: Flevoziekenhuis, afd. Dermatologie, Almere)
- Contact: Angela L. Bosma
| | - Dave Van der Zwaan
- Amsterdam UMC, locatie AMC, afd. Dermatologie, Amsterdam (tevens: Flevoziekenhuis, afd. Dermatologie, Almere)
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17
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Garner M. [Capillary telangiectasia]. Radiologie (Heidelb) 2022; 62:654-658. [PMID: 35792920 DOI: 10.1007/s00117-022-01037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
Brain capillary telangiectasia is usually a small collection of dilated capillary-like vessels. In most cases it is a harmless incidental finding with no clinical significance. They are most commonly located in the pons. In terms of image morphology, they show brush-like signal extinction in T2*/SWI (susceptibility-weighted imaging) sequences and contrast enhancement in T1-weighted images. Other sequences are usually unremarkable unless they involve unusually large capillary telangiectasias. Angiographically they usually remain silent. Sometimes they are associated with venous abnormalities and/or cavernomas. Their distinctive radiographic features usually allow for a reliable diagnosis. Differential diagnostic considerations, such as differentiation from a tumorous or inflammatory process, are sometimes necessary.
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Affiliation(s)
- Malvina Garner
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66424, Homburg-Saar, Deutschland.
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18
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González-Martínez OG, Ortiz J, Quiñones S, Alicea JG, Guevara F, Pérez A, Pappaterra M, Requejo-Figueroa GA, Amaral C, Rivera-Grana E, Villegas VM, Quiñones C, Emanuelli A, Oliver AL. Characteristics Upon Presentation of Patients with Type 2 Macular Telangiectasia in Puerto Rico. P R Health Sci J 2022; 41:9-12. [PMID: 35438889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To describe the systemic disease associations and clinical features upon initial presentation of a cohort of patients with type 2 macular telangiectasia who live in Puerto Rico. METHODS A retrospective review of patients with macular telangiectasia was performed in 4 private retina practices in Puerto Rico. The demographic and clinical characteristics were recorded. RESULTS Twenty-one patients who were diagnosed with macular telangiectasia were included in the analysis. The median age of presentation was 62 years; 86% were female, and all patients were Hispanics. The median visual acuity at presentation was 20/50. A prior medical diagnosis of type II diabetes mellitus was found in 15 (71.4%) patients, essential hypertension in 12 (57.1%), and dyslipidemia in 9 (42.9%). All patients had bilateral disease. The most common ocular findings were the presence of right-angle vessels in 32 (76.2%) eyes and angiographic hyperfluorescence temporal to the fovea, found in 22 (52.4%) of the affected eyes. One eye had evidence of choroidal neovascularization. CONCLUSION Our cohort showed a higher prevalence of type 2 diabetes in patients with type 2 macular telangiectasia than in other cohorts. It also supports the findings of other studies showing that macular telangiectasia patients are more likely to have type 2 diabetes and hyperlipidemia. However, the increased prevalence of diabetes and hyperlipidemia may be due to selection bias, and further studies are needed to assess the significance of these findings.
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Affiliation(s)
| | - Jan Ortiz
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | - Sebastián Quiñones
- University of Puerto Rico, Medical Sciences Campus, School of Medicine, San Juan, PR, USA
| | - Jonathan G Alicea
- University of Puerto Rico, Medical Sciences Campus, School of Medicine, San Juan, PR, USA
| | - Francisco Guevara
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | - Alejandro Pérez
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | - Mariella Pappaterra
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | | | - Claudia Amaral
- University of Puerto Rico, Medical Sciences Campus, School of Medicine, San Juan, PR, USA
| | - Erick Rivera-Grana
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | - Victor M Villegas
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | - Cesar Quiñones
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
| | - Andrés Emanuelli
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA; Emanuelli Research and Development Center, Arecibo, PR, USA
| | - Armando L Oliver
- University of Puerto Rico, Medical Sciences Campus, Department of Ophthalmology, San Juan, PR, USA
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Xu J, Liu W, Fan F, Zhang B, Zhao F, Hu Y, Sun C. TEMPI Syndrome: Update on Clinical Features, Management, and Pathogenesis. Front Endocrinol (Lausanne) 2022; 13:886961. [PMID: 35663307 PMCID: PMC9161818 DOI: 10.3389/fendo.2022.886961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
TEMPI (telangiectasias, elevated erythropoietin level and erythrocytosis, monoclonal gammopathy, perinephric fluid collections, and intrapulmonary shunting) syndrome is a rare and newly defined multisystemic disease, which belongs to "monoclonal gammopathy of clinical significances". Due to its rarity, the etiology, pathogenesis, and clinical features of this disease remain largely unknown. Owing to its hidden and diverse clinical manifestations, missed diagnosis and misdiagnosis are common. In recent years, as more patients (including three fatal cases) were identified, some special clinical manifestations other than the typical pentad of TEMPI syndrome have been reported. Meanwhile, several studies attempting to identify the pathogenesis of TEMPI syndrome were conducted. In this review, we summarize the reported clinical characteristics of TEMPI syndrome and discuss the current and potential treatment options for patients with TEMPI syndrome, including those with relapsed/refractory disease. Furthermore, we provide an overview of current knowledge on the pathophysiology of TEMPI syndrome.
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Abstract
To review the various quality of life (QoL) scales specific for chronic venous diseases (CVDs) and provide guidance and a reference for researchers to select the ideal measurement scale before studying QoL in patients with CVDs.The EBSCO, Ovid, PubMed, Wanfang, and CNKI databases were searched for the keywords "vein," "quality of life," and "scale/questionnaire," and various scales used to measure QoL in patients with CVDs. The QoL aspects were investigated and researched, and then, the search results were screened and summarized.A total of 10 major scales related to the QoL in patients with CVDs were included. The scales differed in dimension, reliability, validity, scoring method, evaluation method, and scope of application.The investigator should select the chronic venous disease QoL scale according to the research purpose and subjects, and then implement the scale to compare the specific aspects of QoL in patients with different CVDs.
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21
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Bukina OV, Sinitsyn AA, Pelevin AV. Sclerotherapy of telangiectasias: A prospective, randomized, comparative clinical trial of hypertonic glucose versus sodium tetradecyl sulfate. Vasc Med 2021; 26:297-301. [PMID: 33733965 DOI: 10.1177/1358863x21992853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To compare the disappearance of the telangiectasias after sclerotherapy with 75% glucose (HG) versus 0.2% sodium tetradecyl sulfate (STS). This prospective, randomized clinical trial compared the results of sclerotherapy of the telangiectasias with HG and STS. The primary efficacy end point was telangiectasia disappearance within 14, 28, 42, and 56 days following treatment. The clearing of the vessels was assessed using a six-point scale (from 0 to 5). A total of 159 women were treated (81 in the STS group; 78 in the HG group). The median score of the vessels clearing (IQR) was significantly lower in the STS group than in the HG group: 3 (2-4) versus 4 (3-5) after 56 days, p < 0.001. Pigmentation was frequently observed in the STS group (38.3% vs 2.6%; p < 0.001). In conclusion, throughout the entire follow-up period, sclerotherapy of telangiectasias with glucose was significantly superior to that with STS. Moreover, pigmentation and intravascular clots frequently occurred with STS treatment. Russian Registry of Treatment of Chronic Venous Diseases (RRT CVD) ID: VRCVD 1.005.
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Affiliation(s)
- Oksana Vasilyevna Bukina
- Cardiovascular Department, Doctor Profi, Derzhavin Tambov State University, Tambov, Russian Federation
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22
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Kyriakou G, Gialeli E, Vryzaki E, Georgiou S. Born in the Purple: An Exceptional Case of Cutis Marmorata Telangiectatica Congenita. Acta Dermatovenerol Croat 2020; 28:247-248. [PMID: 33835001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A full-term, 2-day-old female neonate with a congenital non-tender reticular patch that did not disappear with local warming was referred to our department for consultation. The family history as well as the antenatal course and delivery were unremarkable. On examination, we evidenced a fixed, marbled, bluish to deep purple lesion with a fishnet appearance extending over the right side of her body, face, and scalp. There was presence of atrophy of the involved skin, along with ulceration above the right lateral malleolus. Upon blanching, the lesions could not be emptied completely. Routine laboratory studies, chest X-rays, and abdominal and cranial ultrasound scan results were nonsignificant. Head and limb circumferences were within normal ranges. The patient was checked by the ophthalmology and neurology department to screen for associated anomalies, which were not detected. Based on the medical history and clinical presentation, the diagnosis of cutis marmorata telangiectatica congenita was established. The infant's parents were reassured about the benign nature of the cutaneous disorder as well as the need for periodic follow-up on an outpatient basis. Cutis marmorata telangiectatica congenita (CMTC), first described by the Dutch pediatrician Van Lohuizen in 1922, is an exceedingly rare congenital sporadic condition with fewer than 300 cases described in the medical literature to date. Affected infants have discolored vascular patches of skin with a blue-violet marbled appearance. The disorder may present with a segmental or generalized persistent reticular mottling but more frequently has localized distribution over the lower limbs (1,2). Skin lesions are reminiscent of cutis marmorata, a common benign response observed in infants, which resolves with warming of the skin surface. In contrast, CMTC lesions do not disappear with rewarming and occasionally present with ulceration and atrophy of the involved skin (aplasia cutis) (1,3). Cutis marmorata telangiectatica congenita is described as occuring in association with a plethora of extracutaneous malformations, including undergrowth or overgrowth of the involved extremity, ocular and neurological abnormalities, growth and developmental delays, as well as additional vascular anomalies. The pathogenesis is not fully elucidated, but a lethal gene hypothesis has been suggested by some authors, while others indicate that the disorder may be inherited as an autosomal dominant trait with low penetrance (1,2,4). Skin biopsy is nonspecific and differential diagnosis is rarely difficult due to the distinctive appearance of cutaneous lesions, and the diagnosis can thus be established on clinical grounds alone. CMTC can be associated with other congenital syndromes including phacomatosis pigmentovascularis and Adams-Oliver syndrome (2,4). Cutaneous lesions carry a good prognosis and show a tendency for fading or spontaneous resolution over the first years of life in most cases, but the extremity discrepancy tends to persist. A thorough screening for associated anomalies as well as annual controls of skin changes and psychomotor development of the patients should be performed (2-3).
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Affiliation(s)
- Georgia Kyriakou
- Department of Dermatology, University General Hospital of Patras, Rion, Greece, Greece;
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23
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Agnihotri G, Juhl M, Bain M. Cutis Marmorata Telangiectatica Congenita in Identical Triplets. Skinmed 2020; 18:395. [PMID: 33397576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Gaurav Agnihotri
- Department of Dermatology, University of Illinois College of Medicine, Chicago, IL;
| | - Mark Juhl
- Department of Dermatology, University of Illinois College of Medicine, Chicago, IL
| | - Michelle Bain
- Department of Dermatology, University of Illinois College of Medicine, Chicago, IL
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Lobo Y, Blake T, Herat A. Asymptomatic disseminated telangiectasias: a rare case of cutaneous collagenous vasculopathy. Dermatol Online J 2020; 26:13030/qt0s39g4tt. [PMID: 33147670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023] Open
Abstract
Cutaneous collagenous vasculopathy (CCV) is a rare idiopathic microangiopathy affecting superficial dermal blood vessels. It is characterized by asymptomatic, disseminated, telangiectatic macules that typically involve the extremities. We report the case of a 58-year-old woman who presented with widespread telangiectasias of three years' duration on the upper extremities and abdomen. Cutaneous collagenous vasculopathy may be underdiagnosed as it is often mistaken for disorders that are morphologically very similar, including generalized essential telangiectasia, hereditary hemorrhagic telangiectasia, and pigmented purpuric dermatosis. The diagnosis of CCV is made histologically and findings feature dilated superficial dermal vessels with thickened walls containing periodic acid-Schiff-positive eosinophilic hyaline material. Effective treatment options for CCV have yet to be established and given its benign disease course, treatment may not be necessary. Pulsed dye laser can be offered to patients for cosmetic improvement but the extent of the disease makes complete lesion clearance challenging in most cases. Given the lesions were asymptomatic our patient declined all offered treatment modalities.
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Affiliation(s)
- Yolanka Lobo
- Department of Dermatology, Mater Hospital Brisbane, Queensland.
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25
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Peterson JD, Friedmann DP, Abdo K, Cahana Z. Efficacy and Safety of Intense Pulsed Light With a KTP/PDLlike Filter for the Treatment of Facial Telangiectasias. J Drugs Dermatol 2020; 19:844-850. [PMID: 33026752 DOI: 10.36849/jdd.2020.10.36849/jdd.2020.4834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND An intense pulsed light (IPL) narrowband "KTP/PDL-like" filter (525–585 nm) may combine the tolerability of the IPL with the precision of KTP and PDL lasers. This study evaluated the impact of IPL with a KTP/PDL-like filter on telangiectasias. METHODS This was a single-center, prospective study of 17 subjects with facial telangiectasias and skin types I–III. Three monthly treatments were performed using this specific filter, with follow-up visits at 1, 3, and 6 months. Telangiectasia improvement was assessed by the investigator and subjects using a 5-point scale. Facial photographs and safety assessments were obtained at each visit. Subject discomfort was evaluated using a visual analog scale (VAS) immediately posttreatment, and subject downtime was recorded at each subsequent visit. RESULTS All facial telangiectasias significantly improved. At 1-month follow-up, >50% lesion clearance was noted in 97.1% of facial (n=36) and 85.7% of non-facial (n=7) lesions, with 73% of subjects satisfied or very satisfied. An increase in mean social downtime (0, 2.3, and 3 days) and VAS scores (3.5, 4.5, and 4.8) with treatments 1, 2, and 3, respectively, mirrored a stepwise increase in fluence with subsequent sessions. CONCLUSIONS The use of a novel IPL narrowband KTP/PDL-like filter can significantly improve facial and non-facial telangiectasias with minimal downtime. J Drugs Dermatol. 2020;19(9):844-850. doi:10.36849/JDD.2020.4834.
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Li JA, Zhong LL, Li B, Jiang DQ, Zhao YL. Diffuse telangiectasia of the colon: A case report. Medicine (Baltimore) 2020; 99:e21106. [PMID: 32846752 PMCID: PMC7447499 DOI: 10.1097/md.0000000000021106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
RATIONALE Colonic telangiectasia, also known as colonic angiodysplasia, refers to arteriovenous malformations that occur in the colon, which are common vascular lesions in the GI tract. PATIENT CONCERNS We report a patient, who was admitted to our hospital for colonoscopy. DIAGNOSES Under a microscope, all the segments of the whole colon and the varicose veins showed multiple flaky spider-like telangiectasia changes. The blood vessels were radially distributed and converged in the center. The largest blood vessel was about 10 mm in diameter and had a smooth surface with no ulcers, erosion, or bleeding. INTERVENTIONS It was recommended that the patient undergo a capsule endoscopy to examine small intestine. OUTCOMES The patient did not agree to endoscopy for personal reasons. During the follow-up half a year later, the patient had no melena with normal range of hemoglobin and red blood cell counts. The fecal occult blood test came out negative. LESSONS While the etiology of colonic telangiectasia remains unclear, it is common in the elderly, and is more associated with geriatric conditions and diseases, especially atherosclerotic diseases. Patients who are diagnosed with colonic telangiectasia but are asymptomatic, do not need further treatment. It is usually recommended to monitor the color of stool and check the hemoglobin and fecal occult blood regularly. Colonoscopy is the main method of diagnosis of colonic telangiectasia, and the positive rate is greater than 90%. This procedure should be performed when there is no bleeding or a small amount of bleeding.
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Affiliation(s)
- Jun-An Li
- Gastroenterology and Center of Digestive Endoscopy
| | - Li-Li Zhong
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic
| | | | | | - Yin-Long Zhao
- Gastroenterology and Center of Digestive Endoscopy
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic
- Cardiovascular Surgery
- Department of Nuclear Medicine, The Second Hospital of Jilin University, Changchun, Jilin, P. R. China
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Abstract
TEMPI syndrome, a disease entity comprising telangiectasia, erythrocytosis with high erythropoietin, monoclonal gammopathy, perinephric fluid collection, and intrapulmonary shunting, was first described by Sykes et al. in 2011. To our knowledge, only 15 cases have been reported worldwide, none of which were in Japan. We herein report a 47-year-old man who had intractable ascites for 2 and a half years and was referred to our department for a peritoneovenous shunt. In addition to ascites, he had telangiectasia, high erythropoietin, monoclonal gammopathy, and perinephric fluid collection. Thus, this is the first case of TEMPI syndrome in Japan.
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Affiliation(s)
- Tatsunori Shizuku
- Center for Hepato-Biliary-Pancreatic and Digestive Disease, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Keiji Matsui
- Center for Hepato-Biliary-Pancreatic and Digestive Disease, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Shinya Yagi
- Department for Radiology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Shogo Iwabuchi
- Center for Hepato-Biliary-Pancreatic and Digestive Disease, Shonan Fujisawa Tokushukai Hospital, Japan
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Chauhan P, Meena D, Kansal NK, Gupta A. Polymorphic Eruption of Extensive Cutaneous Sarcoidosis. Skinmed 2020; 18:180-184. [PMID: 32790617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 40-year-old man presented with a 1-year history of asymptomatic multiple raised reddish lesions that started on the face and gradually progressed in size and number to involve the neck, trunk, and arms. There was no history of fever, fatigue, weight loss, arthralgia, cough, dyspnea, or ocular complaints. Past and family history was insignificant, and no significant drug history could be elicited. On examination, multiple reddish brown, shiny, firm papuloplaques and nodules were present over the face, neck, and arms. There was a reddish brown plaque with central depression and overlying prominent telangiectasia over the left perioral area. The lesions over the posterolateral aspects of the arms were atrophic with peripheral reddish brown papules and central clearing, assuming an annular configuration. There were multiple large indurated subcutaneous and atrophic plaques over the arm and back. The palms, soles, hair, nail, and mucosal areas were not involved.
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Affiliation(s)
- Payal Chauhan
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rishikesh, India;
| | - Dilip Meena
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rishikesh, India
| | - Naveen Kumar Kansal
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rishikesh, India
| | - Arvind Gupta
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
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29
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Nelson G, Cameron MC, Rodriguez-Waitkus PM, Fenske NA. Cutaneous collagenous vasculopathy. Cutis 2020; 105:E23-E24. [PMID: 32186540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Garrett Nelson
- Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Michael C Cameron
- Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Paul M Rodriguez-Waitkus
- Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Neil Alan Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa, USA
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Karasu B, Gunay BO. Comparison of anatomical and visual outcomes following different anti-vascular endothelial growth factor treatments in subretinal neovascular membrane secondary to type 2 proliferative macular telangiectasia. Graefes Arch Clin Exp Ophthalmol 2019; 258:99-106. [PMID: 31768680 DOI: 10.1007/s00417-019-04520-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and visual outcomes following different intravitreal anti-vascular endothelial growth factor (VEGF) treatments in eyes with subretinal neovascular membrane (SRNVM) due to type 2 proliferative macular telangiectasia (Mac Tel 2). MATERIALS AND METHODS A total of 38 eyes of 34 patients who underwent intravitreal aflibercept (IVA), intravitreal ranibizumab (IVR), or intravitreal bevacizumab (IVB) injections secondary to SRNVM due to type 2 proliferative MacTel were retrospectively reviewed. The CMT, central macular volume (CMV), best corrected visual acuity (BCVA), and SFCT were evaluated at baseline and at 2 weeks, at 1 month, and at final visits following treatment. Spectral-domain optical coherence tomography and enhanced depth optical coherence tomography were used for the analysis. RESULTS The mean age of the patients was 58.34 ± 12.48 years (range, 27-79 years). The mean follow-up time was 15.97 ± 6.79 months (range 5-32 months). The mean BCVA showed a statistically significant increase in each group (< 0.001). There was no statistically significant difference in BCVA changes between groups in follow-up periods. There was a significant decrease in CMT following IVA (326.4 ± 168.03 μm to 236 ± 58.33 μm) and IVB (383.71 ± 156.79 μm to 343.85 ± 146.25 μm) (p < 0.001, p = 0.004, respectively) whereas no significant decrease in CMT was observed following IVR (374.57 ± 124.28 μm to 339.71 ± 126.10 μm) (p = 0.65) between baseline and final visit. The SFCT significantly decreased following both IVB and IVR treatments (p = 0.009, p = 0.03, respectively). CONCLUSIONS The IVA, IVR, and IVB were found to be effective with regards to anatomical and visual outcomes in proliferative Mac Tel type 2 patients related with SRNVM. Patients receiving both IVA and IVB needed less injections compared to patients who received IVR. Moreover, IVB and IVR lead to significant decrease in SFCT whereas IVA did not show significant effect on SFCT.
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Affiliation(s)
- Buğra Karasu
- Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mah, Bereketzade Sok. No: 2, Beyoğlu, 34421, Istanbul, Turkey.
| | - Betul Onal Gunay
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
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Terrazzino S, Cargnin S, Deantonio L, Pisani C, Masini L, Canonico PL, Genazzani AA, Krengli M. Impact of ATM rs1801516 on late skin reactions of radiotherapy for breast cancer: Evidences from a cohort study and a trial sequential meta-analysis. PLoS One 2019; 14:e0225685. [PMID: 31756226 PMCID: PMC6874351 DOI: 10.1371/journal.pone.0225685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/11/2019] [Indexed: 12/15/2022] Open
Abstract
The relationship between the ataxia-telangiectasia mutated (ATM) rs1801516 gene polymorphism and risk of radiation-induced late skin side effects remains a highly debated issue. In the present study, we assessed the role of ATM rs1801516 as risk factor for radiation-induced fibrosis and telangiectasia, using the LENT-SOMA scoring scale in 285 breast cancer patients who received radiotherapy after breast conserving surgery. A systematic review with meta-analysis and trial sequential analysis (TSA) was then conducted to assess reliability of the accumulated evidence in breast cancer patients. In our cohort study, no association was found between ATM rs1801516 and grade ≥ 2 telangiectasia (GA+AA vs GG, HRadjusted: 0.699; 95%CI: 0.273–1.792, P = 0.459) or grade ≥ 2 fibrosis (GA+AA vs GG, HRadjusted: 1.175; 95%CI: 0.641–2.154, P = 0.604). Twelve independent cohorts of breast cancer patients were identified through the systematic review, of which 11 and 9 cohorts focused respectively on the association with radiation-induced fibrosis and radiation-induced telangiectasia. Pooled analyses of 10 (n = 2928 patients) and 12 (n = 2783) cohorts revealed, respectively, no association of ATM rs1801516 with radiation-induced telangiectasia (OR: 1.14; 95%CI: 0.88–1.48, P = 0.316) and a significant correlation with radiation-induced fibrosis (OR: 1.23; 95%CI: 1.00–1.51, P = 0.049), which however did not remain significant after TSA adjustment (TSA-adjusted 95%CI: 0.85–1.78). These results do not support an impact of ATM rs1801516 on late skin reactions of radiotherapy for breast cancer, nevertheless further large studies are still required for conclusive evidences.
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Affiliation(s)
- Salvatore Terrazzino
- Department of Pharmaceutical Sciences and Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), University of Piemonte Orientale, Novara, Italy
- * E-mail:
| | - Sarah Cargnin
- Department of Pharmaceutical Sciences and Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), University of Piemonte Orientale, Novara, Italy
| | - Letizia Deantonio
- Radiation Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona-Lugano, Bellinzona, Switzerland
| | - Carla Pisani
- Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy
| | - Laura Masini
- Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy
| | - Pier Luigi Canonico
- Department of Pharmaceutical Sciences and Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), University of Piemonte Orientale, Novara, Italy
| | - Armando A. Genazzani
- Department of Pharmaceutical Sciences and Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), University of Piemonte Orientale, Novara, Italy
| | - Marco Krengli
- Radiotherapy, University Hospital Maggiore della Carità, Novara, Italy
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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Brown B, Jones J, Roman JW. Papules and telangiectases on the distal fingers of a child. Cutis 2019; 103:194-223. [PMID: 31116814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Briana Brown
- Dermatology Department, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | | | - John W Roman
- Dermatology Department, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Struik GM, Godart J, Verduijn GM, Kolkman-Deurloo IK, de Vries KC, de Boer R, Koppert LB, Birnie E, Ghandi A, Klem TM, Pignol JP. A randomized controlled trial testing a hyaluronic acid spacer injection for skin toxicity reduction of brachytherapy accelerated partial breast irradiation (APBI): a study protocol. Trials 2018; 19:689. [PMID: 30558672 PMCID: PMC6298013 DOI: 10.1186/s13063-018-3035-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accelerated partial breast irradiation (APBI) is a treatment option for selected early stage breast cancer patients. Some APBI techniques lead to skin toxicity with the skin dose as main risk factor. We hypothesize that a spacer injected between the skin and target volume reduces the skin dose and subsequent toxicity in permanent breast seed implant (PBSI) patients. METHODS In this parallel-group, single-center, randomized controlled trial, the effect of a subcutaneous spacer injection on skin toxicity among patients treated with PBSI is tested. Eligibility for participation is derived from international guidelines for suitable patients for partial breast radiotherapy, e.g. women aged ≥ 50 years with a histologically proven non-lobular breast carcinoma and/or ductal carcinoma in situ (DCIS), tumor size ≤ 3 cm, node-negative, and PBSI technically feasible. Among exclusion criteria are neoadjuvant chemotherapy, lymphovascular invasion, and allergy for hyaluronic acid. For the patients allocated to receive spacer, after the PBSI procedure, 4-10 cc of biodegradable hyaluronic acid (Barrigel™, Palette Life Sciences, Santa Barbara, CA, USA or Restylane SubQ®, Galderma Benelux, Breda, the Netherlands) is injected directly under the skin using ultrasound guidance to create an extra 0.5-1 cm space between the treatment volume and the skin. The primary outcome is the rate of telangiectasia at two years, blindly assessed using Bentzen's 4-point scale. Secondary outcomes include: local recurrence; disease-free and overall survival rates; adverse events (pain, redness, skin/subcutaneous induration, radiation dermatitis, pigmentation, surgical site infection); skin dose; cosmetic and functional results; and health-related quality of life. A Fisher's exact test will be used to test differences between groups on the primary outcome. Previous studies found 22.4% telangiectasia at two years. We expect the use of a spacer could reduce the occurrence of telangiectasia to 7.7%. A sample size of 230 patients will allow for a 10% lost to follow-up rate. DISCUSSION In this study, the effect of a subcutaneous spacer injection on the skin dose, late skin toxicity, and cosmetic outcome is tested in patients treated with PBSI in the setting of breast-conserving therapy. Our results will be relevant for most forms of breast brachytherapy as well as robotic radiosurgery, as skin spacers could protect the skin with these other techniques. TRIAL REGISTRATION Netherlands Trial Register, NTR6549 . Registered on 27 June 2017.
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MESH Headings
- Brachytherapy/adverse effects
- Brachytherapy/methods
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/radiotherapy
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Dermal Fillers/administration & dosage
- Dermal Fillers/adverse effects
- Female
- Humans
- Hyaluronic Acid/administration & dosage
- Hyaluronic Acid/adverse effects
- Hyaluronic Acid/analogs & derivatives
- Injections, Subcutaneous
- Mastectomy, Segmental
- Middle Aged
- Netherlands
- Radiation Dosage
- Radiodermatitis/diagnosis
- Radiodermatitis/etiology
- Radiodermatitis/prevention & control
- Radiotherapy, Adjuvant
- Randomized Controlled Trials as Topic
- Telangiectasis/diagnosis
- Telangiectasis/etiology
- Telangiectasis/prevention & control
- Time Factors
- Treatment Outcome
- Tumor Burden
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Affiliation(s)
- Gerson M. Struik
- Department of Surgery, Franciscus Gasthuis and Vlietland, PO Box 10900, 3004 BA Rotterdam, The Netherlands
- Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
| | - Jeremy Godart
- Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
| | - Gerda M. Verduijn
- Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
| | | | - Kim C. de Vries
- Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
| | - Raymond de Boer
- Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
| | - Linetta B. Koppert
- Department of Surgery, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
| | - Erwin Birnie
- Department of Statistics and Education, Franciscus Gasthuis and Vlietland, PO Box 10900, 3004 BA Rotterdam, the Netherlands
- Department of Genetics, UMC Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, the Netherlands
| | - Ali Ghandi
- Department of Radiology, Franciscus Gasthuis and Vlietland, PO Box 10900, 3004 BA Rotterdam, the Netherlands
| | - Taco M. Klem
- Department of Surgery, Franciscus Gasthuis and Vlietland, PO Box 10900, 3004 BA Rotterdam, The Netherlands
| | - Jean-Philippe Pignol
- Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE Rotterdam, The Netherlands
- Department of Radiation Oncology, Dalhousie University, 5820 University Avenue, Halifax, NS B3H1V7 Canada
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Wiznia LE, Steuer AB, Penn LA, Meehan SA, Femia AN. Generalized essential telangiectasia. Dermatol Online J 2018; 24:13030/qt2926z3f5. [PMID: 30677795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/17/2019] [Indexed: 06/09/2023] Open
Abstract
The pathophysiology of generalized essential telangiectasia is not well understood. Generalized essential telangiectasia is an uncommon disorder in which widespread telangiectasias of unknown cause develop without associated systemic or antecedent dermatologic disease. We report a case of generalized essential telangiectasia in an otherwise healthy 49-year-old man.
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Affiliation(s)
- Lauren E Wiznia
- The Ronald O. Perelman Department of Dermatology, New York University Langone Health, New York, New York.
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35
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Barland A, Fischer R, Rajpara A. Telangiectatic patch on the neck. Cutis 2018; 102:E14-E15. [PMID: 30235372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Aly Barland
- Department of Dermatology, University of Kansas Medical Center, Kansas City, USA
| | - Ryan Fischer
- Department of Dermatology, University of Kansas Medical Center, Kansas City, USA
| | - Anand Rajpara
- Department of Dermatology, University of Kansas Medical Center, Kansas City, USA
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36
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Beggs SM, McGuinn KP, Santoro AF, Nazarian LN, Lee JB. Reticular Telangiectatic Erythema: A Chronic Hematoma Subsequent to Hip Replacement as an Underlying Cause. Skinmed 2018; 16:199-200. [PMID: 29989542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 78-year-old woman with a history of bilateral hip replacements presented with an ill-defined erythematous plaque with foci of reticulated and indurated areas on the left thigh. Initially, a few weeks after her surgery, a small area of erythema appeared overlying the incision site. Over a 6-month period, the erythema slowly expanded before stabilizing in size (Figure 1). There was no pruritus, pain, or warmth. Orthopedic evaluation found no evidence of infection or malfunction of the hip prosthesis. A skin biopsy revealed telangiectasia of the superficial vessels. Based on the clinical and histopathologic findings, a diagnosis of reticular telangiectatic erythema (RTE) was established. An ultrasound scan revealed a greater trochanteric bursa distended by a chronic, organized hematoma measuring 12 cm at greatest dimension, secondary to a full-thickness tear of the left gluteus minimus (Figure 2), establishing the underlying cause of the RTE in this patient.
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Affiliation(s)
- Sarah M Beggs
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Kathleen P McGuinn
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Anthony F Santoro
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Levon N Nazarian
- Department of Radiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Jason B Lee
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA;
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Abstract
Objective Telangiectasias of the lower legs are intradermal dilatations of the subpapillary venous plexus, but their pathophysiology and risk factors are still largely unknown. The purpose of this review is to summarize the current knowledge on the pathophysiology and risk factors for telangiectasias. Methods A systematic review of the literature indexed in Medline completed with textbooks and European phlebology journals from the French, Swiss, and German phlebology societies was performed. Results A multitude of risk factors and several pathophysiological hypotheses, such as reflux, arterio-venous micro-shunts, parietal, and connective tissue abnormalities, are described in the literature. The different hypotheses are discussed and put in a clinical perspective, in particular their therapeutic implications for phlebologists. Conclusion In conclusion, pathophysiology and risk factors of telangiectasias are still largely unknown, and a better understanding could improve treatment results and reduce recurrence.
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Affiliation(s)
- P Kern
- 1 Private Practice in Vascular Medicine, Vevey, Switzerland
- 2 Service of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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38
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Reticular rash in a neonate. J Paediatr Child Health 2018; 54:208. [PMID: 29417663 DOI: 10.1111/jpc.2_13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/12/2017] [Accepted: 09/16/2017] [Indexed: 12/01/2022]
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Bogachev VI, Kuznetsov MR, Lobanov VN, Turkin PI. [Cryocompression sclerotherapy of reticular veins and teleangiectasias]. Angiol Sosud Khir 2018; 24:92-97. [PMID: 30321152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Compression serves as an important component for carrying out successful and safe phlebosclerosing treatment. At the same time, the necessity of wearing compression hosiery or bandages is associated with known limitations and objections of patients, especially in a hot season. We comparatively assessed efficacy of usual compression stockings and a short-term pneumatic bandage with cryoelements while carrying out sclerosing treatment of dilated intradermal veins. Our open prospective observational study included a total of fifty 18-to-35-year-old women. After performing standardized sclerotherapy of reticular veins and telangiectasias on the symmetrical portions of the lower limbs, a pneumatic cryocompression bandage with a pressure of 50 mmHg was applied onto one of the limbs for 15 minutes, with a class 2 compression (RAL standard) medical stocking put on the other limb to be worn by the patients at daytime for 10 days. We assessed completeness of obliteration of the target veins, frequency of the development of typical undesirable events (ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis), as well as the composite discomfort score according to an 11-point visual analogue scale. It was determined that using the pneumatic bandage with cryoelements as compared with the traditional compression stockings significantly decreased the frequency of the development of typical undesirable events after phlebosclerosing treatment, such as formation of ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis. Significance of differences was revealed as early as 7 days after sclerotherapy, to be increasing during further dynamic follow up. By convenience for the patients, the use of the short-term pneumatic cryobandage was four times better than wearing the compression stockings. A conclusion was drawn that while carrying out sclerotherapy of reticular veins and telangiectasias short-term pneumatic cryocompression by efficacy and safety was not inferior to the traditional medical stockings (RAL standard) and made it possible to significantly decrease the incidence of the known undesirable events after phlebosclerosing treatment.
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Affiliation(s)
- V Iu Bogachev
- Russian National Research Medical University named after N.I. Pirogov under the RF Ministry of Public Health, Moscow, Russia
| | - M R Kuznetsov
- Russian National Research Medical University named after N.I. Pirogov under the RF Ministry of Public Health, Moscow, Russia
| | - V N Lobanov
- Russian National Research Medical University named after N.I. Pirogov under the RF Ministry of Public Health, Moscow, Russia
| | - P Iu Turkin
- Russian National Research Medical University named after N.I. Pirogov under the RF Ministry of Public Health, Moscow, Russia
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40
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Shaver CM, Cusack CA. Red patches on a newborn. Cutis 2017; 100:E11-E12. [PMID: 29360901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Carrie A Cusack
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
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41
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Zhou Y, Jiang M, Tang ST, Yang L, Zhang X, Yang DH, Xiong M, Li S, Cao GQ, Wang Y. Laparoscopic finding of a hepatic subcapsular spider-like telangiectasis sign in biliary atresia. World J Gastroenterol 2017; 23:7119-7128. [PMID: 29093620 PMCID: PMC5656459 DOI: 10.3748/wjg.v23.i39.7119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/23/2017] [Accepted: 09/13/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the diagnostic value of a laparoscopic finding of a hepatic subcapsular spider-like telangiectasis (HSST) sign in biliary atresia.
METHODS A retrospective study was conducted first and then a validation set was used to investigate the value of an HSST sign in predicting biliary atresia (BA). In the retrospective study, laparoscopic images of the liver surface were reviewed in 126 patients with infantile cholestasis (72 BA patients and 54 non-BA cholestasis patients) and a control group of 38 patients with non-hepatic conditions. Analysis was first made by two observers separately and finally, a consensus conclusion was achieved. Then, the diagnostic value of the HSST sign was validated in an independent cohort including 45 BA and 45 non-BA patients.
RESULTS In the retrospective investigation, an amplified HSST sign was found in all BA patients, while we were unable to detect the HSST sign in 98.1% of the 54 non-BA patients. There was no HSST sign in any of the control subjects. In the first review, the sensitivity and specificity from one reviewer were 100% and 98.1%, respectively, and the results from the other reviewer were both 100%. The consensus sensitivity and specificity were 100% and 98.1%, respectively. The HSST sign was defined as being composed of several enlarged tortuous spider-like vascular plexuses with two to eight branches distributed on all over the liver surface, which presented as either a concentrated type or a dispersed type. In the independent validation group, the sensitivity, specificity, positive predictive value and negative predictive value of the HSST sign were 100%, 97.8%, 97.8% and 100%, respectively.
CONCLUSION The HSST sign is characteristic in BA, and laparoscopic exploration for the HSST sign is valuable in the diagnosis of BA.
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Affiliation(s)
- Ying Zhou
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Meng Jiang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Shao-Tao Tang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Li Yang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Xi Zhang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - De-Hua Yang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Meng Xiong
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Shuai Li
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Guo-Qing Cao
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Yong Wang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
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42
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Poliak N, Rainey A. Concurrent Sturge-Weber syndrome, facial infantile hemangioma, and cutis marmorata telangiectatica congenita. Cutis 2017; 100:252-254. [PMID: 29136059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present a unique case of 3 vascular malformations-Sturge-Weber syndrome (SWS), facial infantile hemangioma (IH), and cutis marmorata telangiectatica congenita (CMTC)-with dermatologic manifestations presenting in the same patient. This case highlights the possibility of occurrence of multiple vascular malformations in the same patient; the potential role of epigenetic factors; and the importance of a multidisciplinary approach to diagnose, treat, and manage this complicated interplay of vascular abnormalities to achieve the best outcome.
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Affiliation(s)
- Nina Poliak
- Wright Center of Graduate Medical Education, Scranton, and Lehigh Valley Health Network, Children's Clinic, Allentown, Pennsylvania; and Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Anthony Rainey
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
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43
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Fernández-Crehuet P, Ruiz-Villaverde R. Essential telangiectasia in an infant: a diagnosis to be considered. Dermatol Online J 2017; 23:13030/qt8m27b1x4. [PMID: 29469756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 06/08/2023] Open
Abstract
Essential generalized telangiectasia as the result of postcapillary venule dilatation, is characterized by the sudden development of generalized telangiectasias, sometimes involving the conjunctiva. A few pediatric cases have been reported. The main condition in the differential diagnosis includes syndromes with telangiectasia such as hereditary hemorrhagic telangiectasia of Rendu-Osler, unilateral nevoid telangiectasia, and neonatal lupus erythematous. We present an 11-month-old boy that presented because of telangiectasia located on the face and neck. The telangiectasias appeared at two months of age and followed a progressive course. Nd-YAG laser therapy could be an interesting therapeutic approach in cosmetically compromised cases.
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Affiliation(s)
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Dermatologist MD PhD, Complejo Hospitalario de Granada, Granada, Spain.
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44
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Wilmas K, Wohlmuth-Wieser I, Duvic M. Telangiectasia macularis eruptiva perstans: an old terminology, still frequently used. Dermatol Online J 2017; 23:13030/qt6zx243zm. [PMID: 29469737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 06/08/2023] Open
Abstract
The term telangiectasia macularis eruptiva perstans (TMEP) was originally used to describe a rare form of cutaneous mastocytosis (CM) that was limited to the skin with lesions consisting of irregular, telangiectatic macules ranging in color from red to brown. Recent guidelines, however, recommended that the sole presence of telangiectasias should not form the basis of a distinct variant of CM. We conducted a review of the literature from 1930 to 2017 and found 76 cases that were reported as TMEP. Owing to a general misconception about diagnosis of CM and SM, there is a need for further discussion and awareness of the newly proposed World Health Organization (WHO) guidelines.
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Affiliation(s)
- Kelly Wilmas
- John P. and Kathrine G. McGovern Medical School at the University of Texas Health Science Center, Houston, Texas Department of Dermatology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
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45
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Heymann WR. Telangiectasia Macularis Eruptiva Perstans Revisited. Skinmed 2017; 15:287-288. [PMID: 28859740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Warren R Heymann
- Division of Dermatology, Departments of Medicine and Pediatrics, Cooper Medical School of Rowan University, Marlton, NJ;
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46
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Tumer G, Jow T, McElligott S, Schwartz RA, Lambert WC. Telangiectasia Macularis Eruptiva Perstans: Report of Three Cases. Skinmed 2017; 15:171-174. [PMID: 28705275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Telangiectasia macularis eruptiva perstans (TMEP) is a rare, heterogeneous disease of mast cell proliferation. The variable clinical presentation of TMEP, coupled with its rarity, makes the recognition and diagnosis of this disease difficult and challenging for clinicians. The histopathologic findings with hematoxylin and eosin staining that distinguish TMEP from a normal skin biopsy can be so subtle that confirmation of the diagnosis with additional special stains (c-Kit, Giemsa, toluidine blue) is strongly recommended. We describe three cases that highlight the variable clinical presentation of TMEP. One patient experienced only a localized skin manifestation, another an aggressive clinical course with systemic involvement, and a third diffuse skin involvement with mild fatigue, muscle pain, and weight gain.
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Affiliation(s)
- Gizem Tumer
- Departments of Pathology, Rutgers University - New Jersey Medical School, Newark, NJ
| | - Tiffany Jow
- Departments of Dermatology, Rutgers University - New Jersey Medical School, Newark, NJ
| | - Sean McElligott
- Departments of Pathology, Rutgers University - New Jersey Medical School, Newark, NJ
| | - Robert A Schwartz
- Departments of Dermatology, Rutgers University - New Jersey Medical School, Newark, NJ
| | - W Clark Lambert
- Departments of Dermatology, Rutgers University - New Jersey Medical School, Newark, NJ;
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47
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García-Colmenero L, Curto-Barredo L, Gómez-Martin I, Gallardo F, Pujol RM. Telangiectatic Mycosis Fungoides: A New Clinicopathological Presentation Mimicking Acquired Naevoid Telangiectasia. Acta Derm Venereol 2017; 97:651-652. [PMID: 28093597 DOI: 10.2340/00015555-2613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Lidia García-Colmenero
- Department of Dermatology, Hospital del Mar. Parc de Salut Mar., Passeig Marítim 25-29, ES-08003 Barcelona, Spain.
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48
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Pizzorni C, Giampetruzzi AR, Mondino C, Facchiano A, Abeni D, Paolino S, Ruaro B, Smith V, Sulli A, Cutolo M. Nailfold capillaroscopic parameters and skin telangiectasia patterns in patients with systemic sclerosis. Microvasc Res 2016; 111:20-24. [PMID: 27989404 DOI: 10.1016/j.mvr.2016.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To correlate nailfold capillaroscopic parameters with the presence of skin telangiectases (TAs) in systemic sclerosis patients (SSc). METHODS Thirty-three consecutive patients (28 women and 5 men, mean age 59±21years) affected by SSc according to the ACR/EULAR criteria, 30 with limited (lcSSc) and 3 with diffuse (dcSSc) skin disease, displaying the presence of skin TAs on face, hands, forearms, neck, and décolleté were recruited. Nailfold videocapillaroscopy (NVC) was performed to classify the patients into one of the three main patterns of SSc microangiopathy ("early", "active", "late"), and to calculate the microangiopathy evolution score (MES). SSc patients underwent also dermoscopy (DS) for the analysis of the TA score and patterns (spot or reticular). Possible correlations between clinical findings, serum autoantibodies, TA patterns and both NVC patterns and MES were investigated. RESULTS The "late" NVC pattern was found associated with a highest total number of TAs (p=0.005): in particular both "spot" and "reticular" TA patterns were found equally distributed in SSc patients with the "late" pattern. High MES values were found associated with the highest total number of TAs (p=0.003), with the "reticular" but not with the "spot" DS pattern (p=0.003) and with the "late" pattern of microangiopathy (p=0.001). CONCLUSIONS The severity of nailfold microangiopathy seems to correlate in SSc patients with both progressive cutaneous microvascular abnormalities and Medsger's severity score, as evaluated by NVC analysis and DS. The assessment of the microvascular damage may be useful not only during the onset of SSc for the early diagnosis, but also to monitor its evolution.
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Affiliation(s)
- Carmen Pizzorni
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino-IST Genova, Italy
| | - Anna R Giampetruzzi
- Department of Dermatology, Dermoscopy and Nailfold Capillaroscopy Services, Istituto Dermopatico dell'Immacolata IDI-IRCCS FLMM, Rome, Italy
| | | | - Antonio Facchiano
- Research Laboratory, Istituto Dermopatico dell'Immacolata IDI-IRCCS FLMM, Rome, Italy
| | - Damiano Abeni
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS FLMM, Rome, Italy
| | - Sabrina Paolino
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino-IST Genova, Italy
| | - Barbara Ruaro
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino-IST Genova, Italy
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Alberto Sulli
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino-IST Genova, Italy
| | - Maurizio Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino-IST Genova, Italy.
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Wirotpaisankul P, Wannaprasert T, Treesirichod A. Cutis Marmorata Telangiectatica Congenita: Clinical Features in 7 Cases. J Med Assoc Thai 2016; 99 Suppl 8:S227-S230. [PMID: 29906051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cutis marmorata telangiectatica congenita (CMTC) is a sporadic congenital vascular anomaly usually presents at birth as a localized or generalized reticulated, erythema and telangiectasia. The pathogenesis of CMTC is unknown. Additional anomalies have been frequently reported in association with CMTC. This article describes the characteristics of the clinical presentations in a series of 7 children with CMTC in HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Thailand. Both genders were almost equally affected (3 male/4 female). The lower limbs were involved in 7 patients (100%), the trunk in 3 patients (42.9%), and the upper limbs in 1 patient (14.3%). There were 2 patients (28.6%) who presented with the involvement of both trunk and limbs. The mean of the body surface area involved was 17% (2-50). Asymmetry of affected limbs were found in 2 patients (28.6%). On follow-up, improvement of reticulated lesions was noted in all patients. The prognosis of uncomplicated cases is good. No specific treatment is needed. The skin lesions usually disappear gradually.
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50
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Heymann WR. Cutaneous Collagenous Vasculopathy-Associated Benign Pigmented Purpura. Skinmed 2016; 14:308-309. [PMID: 27784525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 68-year-old woman presented with an asymptomatic eruption predominantly on the proximal pretibial region of the right lower extremity, which had been present for many months. Her medical history was remarkable for diabetes and hypothyroidism. Physical examination demonstrated "cayenne pepper"-like brown macules, scattered petechiae, and multiple minute, blanching telangiectasias (Figure 1) that were more evident on dermatoscopy (Figure 2). The clinical differential diagnosis included a benign pigmented purpura (BBP; Schamberg type), telangiectasia macularis eruptiva perstans, cutaneous T-cell lymphoma, essential telangiectasia, and cutaneous collagenous vasculopathy (CCV). Results from complete blood cell count, hepatic profile, and serum tryptase were normal. Findings from skin biopsy demonstrated ectatic papillary dermal vessels with hyalinized walls (accentuated by a periodic acid-Schiff stain), a sparse superficial perivascular mononuclear infiltrate, extravasated erythrocytes, and focal siderophages (Figure 3). The diagnosis of CCV with an associated BPP was confirmed.
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Affiliation(s)
- Warren R Heymann
- Departments of Medicine and Pediatrics, Division of Dermatology, Cooper Medical School of Rowan University, Marlton, NJ;
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