Cases reported "Port-Wine Stain"

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1/67. Possible hazards of cryogen use with pulsed dye laser. A case report and summary.

    BACKGROUND: Pulsed dye laser treatment of port-wine stains is safe and effective. However, the pain associated with this treatment is often difficult to tolerate, especially for children. A laser-coupled delivery system known as dynamic epidermal cooling has recently been developed to improve local anesthesia. OBJECTIVE: To report laser ignition of a commercially-available, hand-held cryogen spray used for local anesthesia, and describe possible mechanisms of the fire; to define the chemical characteristics of other skin coolants suitable and unsuitable for skin cooling with laser treatment. methods: Case report and literature review. CONCLUSIONS: Clinicians must be aware of the thermodynamic properties, potential for skin damage, cost and environmental consequences of commercially available cryogens before considering their use for topical anesthesia with laser surgery. ( info)

2/67. Prepartum mixed type cavernous-capillary hemangioma arising in nevus flammeus.

    OBJECTIVE: Capillary hemangioma may appear de novo and involute during the first decade of life, but rarely during pregnancy. This study describes the clinical and histologic findings of an eyelid mixed type cavernous-capillary hemangioma arising in a nevus flammeus and discusses the differential diagnosis of this lesion. STUDY DESIGN: Clinicopathologic case report. INTERVENTION: A reddish, protruding eyelid mass arising from a nevus flammeus at the eyelid margin in a 26-year-old woman was monitored during her pregnancy. Postpartum, the mass was excised and examined histologically. RESULTS: The lobulated tumor recurred during the second pregnancy and partially regressed following delivery. It was composed of mixed elements of cavernous and capillary hemangioma that superficially resembled Kaposi sarcoma, set against the background of a nevus flammeus. CONCLUSION: The differential diagnosis of discrete prepartum vascular tumor arising in nevus flammeus includes mixed capillary-cavernous hemangioma, pseudo-Kaposi sarcoma, granuloma gravidarum, and angiodermatitis. A common stimulus during pregnancy may be the inciting factor for the development of these tumors. ( info)

3/67. Atrophie blanche-like scarring after pulsed dye laser treatment.

    Pulsed dye laser treatment is well established for the treatment of port-wine stains and other vascular skin lesions. Although hyperpigmentation is quite common, other side effects such as hypopigmentation and atrophic scarring occur infrequently, and hypertrophic scarring is rare. ( info)

4/67. Naevus varicosus osteohypertrophicus. An early diagnostic approach.

    Naevus varicosus osteohypertrophicus (synonym Klippel-Trenaunay syndrome KTS) is relatively rare circumscribed, usually quadrant-related gigantism with vascular hyperplasia or malformations based on the embryonic development. The authors observed an 18- and a 30-year-old female with a triad of symptoms: cutaneous nevus flammeus, varicose and dilated veins, and bony and soft tissue hypertrophy of the low limb. The second patient also had two venous ulcers as a dominant clinical feature--a rare manifestation of Klippel-Trenaunay syndrome. A diagnosis of Klippel-Trenaunay syndrome was made by clinical observations, laboratory findings, dermoscan, radiological examination of the bones of the limb, Doppler ultrasonography, photopletismography and venoscan. A bone isotope scan was also done to the first patient. Making an early diagnosis of this sporadic congenital disease with unknown aetiology is important in order to be able to provide early prophylactic and therapeutic measures. Klippel and Trenaunay in 1900 were the first to describe a patient with the simultaneous appearance of osteohypertrophy, hemangiomas and varicose veins involving one extremity [1]. In 1907 Parkes and Weber reported a similar syndrome--they described a patient who had dilated and pulsatile arteries in the affected region including the presence of arterio-venous communications. In 1918 they used the compromise term "haemangiectatic hypertrophy" to embrace all conditions which were associated with congenital vascular malformations including A-V anastomoses associated with bone and soft tissue hypertrophy. Most authors are agreed that Klippel-Trenaunay syndrome and the syndrome of multiple congenital arterio-venous fistulae are two separate features of the Parkes Weber hypertrophy. KTS is manifesting with a triad of symptoms: cutaneous vascular nevus (more frequently nevus flammeus type), superficial venous varicosities and hypertrophy of the affected limb. Usually one quadrant of the body is involved: quite often a leg, an arm, lateral side of the trunk, very rarely the face. More than one quadrant and bilateral involvement are rarely affected. Naevus flammeus appeared at birth. It is extremely variable both in extent and in color--the latter ranging from pale pink to deep purple. Veinous varicosities appear in childhood and adolescence. They are painful and may be complicated by superficial or deep venous thrombosis and rarely, ulceration. hypertrophy of the affected extremities is due to bone and soft tissue hypertrophy. KTS can be associated with other developmental anomalies such as: polydactyly, syndactyly, oligodactyly [2] macrocephaly, blue nevus, epidermal naevus, venous malformations. ( info)

5/67. Vascular tumors arising in port-wine stains: two cases of pyogenic granuloma and a case of acquired tufted angioma.

    Three female patients affected by intradermal vascular tumors were presented. The lesions were acquired and developed from preexisting port-wine stains (PWS). Among the three patients observed, two had a pyogenic granuloma (PG) and the third patients had tufted angiomas. As reported earlier, formation of a PG within the lesion of a PWS supports the assumption that arteriovenous anastomoses are associated with its pathogenesis. Occurrence of tufted angioma from a PWS, as well as coexisting but separate PWS has been reported. However, the tufted angiomas of our patient were located in different sites, one in the PWS and others separate from the PWS. This has never previously been reported. ( info)

6/67. Port-wine-stain (nevus flammeus), congenital Becker's nevus, cafe-au-lait-macule and lentigines: phakomatosis pigmentovascularis type Ia--a new combination.

    A 16-year-old male had brown macules in a geographic pattern with increased terminal hair on the back and dusky red partially blanchable non progressing macules on his left thigh since birth. Clinical diagnoses of Becker's nevus and port-wine-stain were made and confirmed histopathologically. In addition, he had multiple lentigines on the face and trunk and a single cafe-au-lait-macule on his chest. ( info)

7/67. Treatment of vascular lesions in pigmented skin with the pulsed dye laser.

    BACKGROUND: Vascular lesions occurring in African-American patients are often not treated because of the risk of local side effects. OBJECTIVE: The study was to determine the efficacy of the flashlamp-pumped dye (FLPD) laser in the treatment of vascular malformations in African-American patients. methods: All lesions in three patients were treated with the FLPD laser using a 585 nm wavelength, 5 mm spot size, 450 pulse width, and fluences ranging from 6.5 to 8.5j per cm2. CONCLUSION: The FLPD was effective in treating vascular malformations. Transient changes in colour and skin texture occurred at the treated sites. ( info)

8/67. Phacomatosis pigmentovascularis type IIa successfully treated with two types of laser therapy.

    We describe a 28-year-old Japanese woman with phacomatosis pigmentovascularis type IIa who was treated by 27 sessions of Q-switched ruby laser irradiation to the site of dermal melanosis on her face and three sessions of dye laser irradiation to the port-wine stain on her left cheek. This is the first report of the successful treatment of a cutaneous lesion in a patient with phacomatosis pigmentovascularis. As the outcome of the treatments was excellent, we conclude that phacomatosis pigmentovascularis type IIa can be treated successfully by the combination of the two types of laser therapy. ( info)

9/67. Mixed capillary/lymphatic malformation with coexisting port-wine stain: treatment utilizing 3D MRI and CT-guided sclerotherapy.

    BACKGROUND: Lymphatic malformation, a benign malformation of the skin and the subcutaneous tissues, is divided into two major groups: the classical and the localized forms. Pathologically lymphatic malformation often consists of sequestered lymphatic cisterns with thick muscle walls lying deeply in the subcutaneous tissue. Communicating via dermal lymphatic channels with superficial pseudovesicles, they can vary in size depending on the pressure transmitted by the cisterns beneath. methods: We present a patient with mixed capillary/lymphatic malformation and coexisting port-wine stain since birth. To demonstrate the anatomic extent and the subcutaneous involvement we performed a 3D reconstruction of a magnetic resonance imaging (MRI). The diagnostic procedures, therapeutic possibilities, and complications regarding this rare appearance are reviewed. RESULTS: Good results could be obtained with CO2 laser vaporization of the superficial lesions and computed tomography (CT)-guided transcutaneous sclerotherapy for the deeper cisterns with doxycycline. CONCLUSION: The combination of CO2 laser treatment and sclerotherapy with doxycycline seems to present a treatment option for cutaneous and subcutaneous lymphangioma circumscriptum with rare side effects. ( info)

10/67. Acquired port-wine stains and antecedent trauma: case report and review of the literature.

    BACKGROUND: While cases of congenital port-wine stains (PWSs) are relatively common, cases of acquired PWSs are quite rare. Many of the reported cases of the acquired type have been reported to be related to previous trauma. OBSERVATIONS: We encountered a case of acquired PWSs in a 3-year-old girl. Her parents noted that the lesions appeared in areas of antecedent trauma. This prompted us to review all reported cases of acquired PWSs and to assess the relationship to trauma. Among the 59 cases reported, there was a slight female predominance (female-male ratio, 35:24). Seventeen (29%) of the cases were related to trauma. One report evaluated the effectiveness of lasers in the treatment of acquired PWSs and found that 54% of patients treated with pulsed dye lasers had an excellent response or complete clearance. CONCLUSIONS: Port-wine stains are not only congenital but can be acquired as well. Trauma can be one of the causes of acquired PWSs. To explain this phenomenon, various theories, including abnormal vascular repair and altered vascular innervation, have been proposed. lasers are the treatment of choice in all cases of PWSs and may be more effective in those that are acquired. ( info)
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