ABSTRACT
BACKGROUND: Anatomic location and depth of ectasia of port-wine stains (PWSs) are important prognostic indicators when evaluating treatment options for patients. Videomicroscopy permits subsurface evaluation of PWSs, thereby allowing determination of the depth of the ectatic vessels. OBJECTIVE: Our purpose was to determine whether location of PWSs corresponds to the depth of the ectatic vessels. METHODS: Seventeen patients presenting for evaluation or treatment of PWSs underwent videomicroscopy with a Video Loupe 7EX microscope. Data were recorded by location of the PWS as a type 1 lesion (blobs or globular structures) corresponding to ectasia of the superficial capillary loops, a type 2 lesion (rings) corresponding to ectasia of the deeper horizontal plexus, or a mixed pattern. RESULTS: PWSs in areas that typically respond well to laser treatment (V3, neck, and trunk) were more likely to have a superficial type 1 pattern. PWSs in areas that have a poorer response to therapy (V2, distal extremities) were more likely to have a deeper type 2 pattern. CONCLUSION: We found that patients with lesions in the V3 dermatome and on the trunk and neck have more superficially ectatic vessels, whereas those lesions in dermatome V2 and on the distal extremities have more deeply placed vessels. Further studies are needed to determine whether videomicroscopy can be used to preoperatively predict treatment results.
Subject(s)
Port-Wine Stain/pathology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Laser Therapy , Male , Microscopy, Video , Middle Aged , Port-Wine Stain/classification , Port-Wine Stain/surgery , Predictive Value of Tests , PrognosisABSTRACT
BACKGROUND: Erythema gyratum repens is a rare, clinically specific, and distinctive paraneoplastic syndrome. It is associated with internal malignancy in 82% of patients. OBJECTIVE: A 58-year-old man with erythema gyratum repens is described. On diagnosis of his eruption, a malignancy work-up revealed a 9-mm pulmonary adenocarcinoma. Removal of the carcinoma resulted in clearing of the erythema. RESULTS: Erythema gyratum repens is most commonly associated with bronchial, esophageal, and breast cancer. It has also rarely been reported in patients without evidence of malignancy. The histopathologic findings are nonspecific. Direct immunofluorescence has sometimes revealed C3, C4, or immunoglobulin G at the basement membrane zone. CONCLUSION: The etiology of erythema gyratum repens is unknown, although an immune response is postulated. Treatment involves treating the underlying malignancy.
Subject(s)
Erythema/diagnosis , Erythema/etiology , Erythema/therapy , Female , Humans , Lymphocytes/immunology , Male , Middle Aged , Sex Ratio , White PeopleABSTRACT
BACKGROUND: Linear scleroderma is a cutaneous disease of unknown etiology. It most often affects children, who develop band-like lesions in an asymmetric distribution. The literature is reviewed as to the diagnosis, pathogenesis, and treatment of linear scleroderma. CASE REPORT: Six new cases of linear scleroderma in children are reported. Their ages ranged from 6 to 17 years, and five were girls. A 17-year-old girl had en coup de sabre. Multiple treatment modalities were used. All laboratory testing was negative. CONCLUSIONS: Linear scleroderma is a clinical diagnosis. The pathogenesis remains unknown. A consistently effective therapy has not been found, although diphenylhydantoin and ticlopidine hydrochloride should be evaluated in clinical trials.
