Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antifungal Agents/therapeutic use , Naphthalenes/administration & dosage , Pemphigus, Benign Familial/drug therapy , Tinea/drug therapy , Humans , Male , Middle Aged , Pemphigus, Benign Familial/microbiology , Terbinafine , Treatment Outcome , Trichophyton/isolation & purificationABSTRACT
Toxic epidermal necrolysis (TEN) is a life-threatening, immune-mediated reaction, characterized by severe cutaneous and mucosal blisters and erosions. It often presents with flu-like symptoms, followed by a maculopapular, urticarial, purpuric or erythema multiforme-like eruption, which then evolves into blisters and sheet-like erosions. Presentation with pustules, however, is not well described in the English literature, and may lead to delayed diagnosis. We present two unusual cases of TEN that initially presented with pustular lesions.
Subject(s)
Erythema Multiforme/pathology , Stevens-Johnson Syndrome/pathology , Biopsy , Diagnosis, Differential , Erythema Multiforme/immunology , Female , Humans , Male , Middle Aged , Severity of Illness Index , Stevens-Johnson Syndrome/immunology , Young AdultABSTRACT
BACKGROUND: Children with excessive hair may have severe psychological consequences. Laser hair removal in adults is known to be safe and well tolerated, but this is less well established in children. OBJECTIVE: To describe our experience with laser hair removal in children, and to investigate the safety and tolerability of this procedure in children. METHODS: The case records of 24 children aged < 16 years, who had received a minimum of three treatments for hair removal were analysed retrospectively. For patients with Fitzpatrick skin phototype II-IV, the lasers used were a long-pulse alexandrite (755 nm) with either continuous chilled-air cooling at fluences of 16-27 J/cm(2) or a long-pulse alexandrite with cryogen cooling at fluences of 16-32 J/cm(2). For patients with Fitzpatrick skin phototype IV-VI, lasers used were a long-pulse Nd:YAG (1064 nm) with a chilled contact sapphire tip at fluences of 20-35 J/cm(2) or a long-pulse Nd:YAG with cryogen cooling at fluences of 16-26 J/cm(2). RESULTS: Mean age at first treatment was 12.3 years. Diagnoses were constitutional hirsutism (14 patients), polycystic ovarian syndrome (five), congenital melanocytic naevus (two), generalized hypertrichosis (two) and naevoid hypertrichosis (one). One patient required a general anaesthetic, eight required topical anaesthetic cream, and 15 did not require any form of anaesthesia. Intolerable discomfort requiring adjustment in fluence was the only recorded side-effect, affecting two cases. There were no incidences of blistering, infection, dyspigmentation or scarring. CONCLUSION: When administered appropriately, laser hair removal is safe and well tolerated in children aged < 16 years.
Subject(s)
Hair Removal/methods , Hirsutism/radiotherapy , Hypertrichosis/radiotherapy , Low-Level Light Therapy , Adolescent , Anesthesia/methods , Anesthesia/psychology , Child , Child, Preschool , Female , Hirsutism/psychology , Humans , Hypertrichosis/psychology , Low-Level Light Therapy/methods , Male , Patient Satisfaction , Referral and Consultation , Retrospective Studies , Treatment OutcomeABSTRACT
Lasers are frequently used to treat pigmented skin lesions; however, there is little published data from routine clinical practice. We performed a retrospective review of patients treated between January 2003 and January 2004 to describe the patients, methods used and the clinical outcome. The long-term result was determined by a patient questionnaire. In total, 67 patients with 76 pigmented lesions were treated (22 males and 45 females, mean age 22 years); 27% had Fitzpatrick skin types IV-VI. The Q-switched Nd:YAG, and erbium:YAG lasers were used in 75% and 24% of cases, respectively, with an average of 5.4 treatments/patient. The physician-rated outcome at the end of treatment was 'very positive' in 45% and 'mostly positive' in 30% of cases. The patient-rated outcome at an average of 21 months post-treatment was 'excellent' in 29.5%, 'good' in 25%, and 'fair' in 22.7% of the 44 cases. About 50% of patients with the three most common lesions (congenital naevi, other/unspecified naevi and naevus of Ota) achieved good or excellent long-term results.
