ABSTRACT
The purpose is to present a case of iridocorneal endothelium Syndrome with glaucoma and discuss clinical presentation and management strategies. A 45 year old female presented with redness, pain and diminision of vision in left eye. The patient was completely evaluated for the complaints. Slit lamp biomicroscopy revealed semidilated pupil not reacting to light and variation in iris colour pattern. Intraocular pressure was 14mmHg in the right eye and 46mmHg in the left eye. Gonioscopy of the left eye revealed broad based peripheral anterior synechiae. The optic disc of the left eye had a cup of 0.7. Specular microscopy of the left eye showed pleomorphism and polymegathism with multiple guttatae. This case reports the importance of specular microscopy in the evaluation of ICE syndrome and to plan the appropriate management strategies. We performed a trabeculectomy surgery for this patient with a well-functioning bleb to reduce the intraocular pressures following failure of topical anti-glaucoma medications.
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ObjectiveTo evaluate the clinical effects of one stage treatment for the temporal divided naevus of the eyelid.MethodsThe divided naevus infiltrated to the skin,eyelid margin and tarsal plate was completely resected,and co-pedicle double hatchet skin flaps were trimmed.According to the areas of the defects and tension of the sliding flaps,shortening of the eyelids' margins were undertaken.The upper eyelid margin was reconstructed by the downward shift of the tarsal plate.According to the resected height of the tarsal plate,the extended length of the levator aponeurosisMüller's muscle compound was measured.Skin trimming was unnecessary and the incisions were usually closed under no tensions.ResultsEight eyelids of eight cases were treated by this method and followed up for 22 months to 3 years,the eyelids' margins were all in normal positions,without skin chromatic aberration and obvious scar formation.The size of the palpebral fissure and eyelids' movement were normal and no recurrence happened in all patients.Conclusions In addition to the design of the skin flaps,the shortening and reconstruction of the eyelid margin and the balance of the levator palpebrae muscle should also be considered for a bigger temporal divided uaevus in the eyelid.
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Cutis verticis gyrata is characterised by hypertrophy and folding of skin of scalp leading to gyrated appearance. Polan and Butterworth1 classified it into primary and secondary forms. Secondary CVG has been described with a wide variety of causes. Congenital melanocytic neavus appears to be the most common2. However it has been described with other naevoid abnormalities like Neavus lipomatoses, connective tissue nevi, genetic disorders such as neurofibromatoses, and endocrine disorders like acromegaly.
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El siringocistoadenoma papilífero es un raro tumor anexial benigno de naturaleza ecrina o apocrina; o seade histogénesis incierta. Es un tumor de la niñez y adolescencia con muchos ejemplos descritos en el momento del nacimiento. Se asocia a un nevo sebáceo pre-existente en el 30% de los casos. Su diagnóstico es netamente histológico y el tratamiento quirúrgico es curativo.
Syringocystadenoma papilliferum is a rare benign adnexal of eccrine or apocrine nature; uncertain histogenesis. It is a tumour of childhood or adolescence, with many examples noted at birth. The neoplasmoccurs in association with an organoid naevus such as naevus sebaceous in at least one-third of cases. Itsdiagnosis is purely histological and simple excision is curative.
Subject(s)
Humans , Male , Female , Child , Middle Aged , Nevus , Epidermal Cyst , SyringomaABSTRACT
Naevus of Ota is a dermal melanocytic pigmentary disorder that affects predominantly females. It occurs most frequently in Asian populations. Its association with naevus of Ito and a port wine stain is very rare. We report a rare occurrence of these three conditions in a male patient.
ABSTRACT
Background Hori’s naevus is an acquired bilateral naevus of Ota-like macules (ABNOM). It was first reported by Hori et al in 1984. It is common among Asians and has a female preponderance. Hori’s naevus is characterised by blue-brown macules typically on the malar region of the face. Objectives To evaluate the clinical characteristics of patients with Hori’s naevus seen at Hospital Kuala Lumpur and the efficacy of Qswitched neodynium-yttrium-aluminium-garnet (Nd:YAG) laser in the treatment of this condition. Method A retrospective analysis of 16 patients diagnosed clinically with Hori’s naevus and treated with Q-switched Nd:YAG laser was carried out. Patient’s demographic data and clinical characteristics, response to Q-switched Nd:YAG laser, complications and recurrence were reviewed. Results A total of 16 patients diagnosed clinically with Hori’s naevus and treated with Q-switched Nd:YAG laser were reviewed. Fifteen of the patients were female with one male. Their ages ranged from 33-61 years old (mean age = 47). Nine of these patients were Chinese with seven Malays. All had Fitzpatrick skin phototype IV. The age of onset ranged from 15-45 years old. The most common clinical presentation was bilateral brown macules on the malar region of the face. Eleven patients received treatment with Q-switched 1064nm Nd:YAG and five combination treatment with Q-switched 532nm Nd:YAG followed by 1064nm laser. Two patients were lost to follow up after a single treatment. After a single treatment, 13 patients graded their clinical response as ‘poor’ (0-25% improvement) and 1 as ‘fair’ (26-50% improvement). Six patients received a total of two treatments of whom 4 graded their response as ‘fair’ (26-50% improvement) and 2 as ‘good’ (51-75% improvement). Two patients who received a total of four treatments graded their responses as ‘good’ and ‘excellent’ (76-100% improvement) respectively. 10 patients had significant hyperpigmentation post laser treatment. However, none reported any recurrences. Conclusion There is no difference in pigment clearance between concurrent use of Q-switched 532nm Nd:YAG laser followed by 1064nm laser and Q-switched 1064nm Nd:YAG laser for Hori’s naevus. However, there is only minimal improvement after a single treatment, and multiple sessions are required to achieve satisfactory improvement. Post inflammatory hyperpigmentation was the main complication seen.
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Background Naevus of Ota was first described in 1939 by Ota M. It is characterized by a bluish-gray mottled hyperpigmentation in the distribution of the trigeminal nerve. It affects between 0.014 - 0.6% of the Asian population. It is not only physically disfiguring but may be associated with tremendous psychosocial impact on the patient. The aim of the study is to determine the demographic data of local patients with naevus of Ota, their response to treatment with Q-switched 1064nm Nd:YAG laser, complications and recurrence. Materials and Methods A retrospective analysis of all patients with naevus of Ota treated with Q-switched 1064nm Nd:YAG laser between January 1998 to December 2007 was conducted at the dermatology clinic, Kuala Lumpur Hospital. Patients’ demographic data, clinical characteristics, response to Q-switched 1064nm Nd:YAG laser and the complications were reviewed. Results A total of 50 patients with naevus of Ota were treated with Q-switched 1064nm Nd:YAG laser. There were 42 female and 8 male patients with a F : M ratio of about 5:1. The mean age of presentation was 31 years old (11-60 years). More than half were Chinese patients (56%) followed by Malays (38%), Indian (2%) and others (4%). Seventy four percent of the patients had Fiztpatrick skin-type IV and the rest skin type V. Ninety two percent of the patients had unilateral trigeminal dermatomal involvement while 8% had bilateral trigeminal dermatomal involvement. Of the 15 patients who were referred to the ophthalmologist, 10 were found to have scleral involvement and none had glaucoma. Patients who had 2 treatments (13 patients) did not have any significant lightening of their lesions. In the remaining 37 patients who had 3 sessions (mean = 5.7, range 3 -15 sessions), 9 patients (24.3%) reported the response as good (51-75% lightening); 17 patients (45.3%) as excellent (>75% lightening) and 8 patients (22%) had near complete lightening (>90%). None reported any complications or recurrence. Conclusion Q-switched 1064nm Nd:YAG laser is an effective and safe treatment modality for patients with naevus of Ota.
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Objective: To investigate the proliferation of three subtypes of odontogenic keratocysts(OKC), namely simple(not recurrent),recurrent and basal cell naevus syndrome(BCNS) associated lesions. Methods: Ki 67 expression was studied in 34 odontogenic keratocysts(simple, n =10;recurrent, n =12;syndrome, n =12)by biotin streptavidin method using Ki 67 monoclonal antibody after microwave treatment. Ki 67 positive cells were counted manually and related to the area of epithelial lining as determined by computer image analyzer. Results: Ki 67 positive cells per mm 2 in simple odontogenic keratocysts ①, recurrent odontogenic keratocysts ② and BCNS ③ were 1 812.29?606.47, 2 393.88 ?997.08 and 3 983.17?858.92 respectively(① or ② vs ③ P 0.05). Conclusion: The basal cell naevus syndrome associated OKC has a higher rate of epithelial proliferation than non syndrome OKC, the increased epithelial proliferation is correlated with increased recurrence potential. Ki 67 may be an alternative method to differentiate syndrome and non syndrome OKC.
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Sixty-eight cases of naevus fusco-caeruleus zygomaticus were observed from 1990 to 1996 in our clinic. In order to differentiate easily from other pigmented disorders, detailed analysis was carried out. The results showed that this condition principally occurred in young or middle-aged women, manifested as dark greyish spots scattered bilaterally and symmetrically on the zygomatic region. Histopathologically, there were elongated, slender spindle-shaped melanocytes scattered in the upper portion of the dermis, their long axes run parallel to the collagen fibres. It suggests that the naevus reported differs clinically and histopathologieally from naevus of Ota.