ABSTRACT
Dowling-Degos disease (DDD) is a rare autosomal-dominant genodermatosis with limited treatment possibilities. Although the efficacy of ablative laser therapy has been reported, we sought to examine the efficacy of fractional versus full ablative laser therapy in a female patient with DDD in a split-side report. We treated the lesions on the right side of the patient's upper abdomen with an ablative fractional CO2 laser and the lesions on the left side of the upper abdomen with a full ablative Er:YAG laser (erbium-doped yttrium aluminium garnet laser) three times at monthly intervals. After three laser sessions, the lesions treated with the Er:YAG laser showed a complete response, whereas the fractional CO2 laser treatment was less effective. After the three treatments were performed, the right side of the patient's upper abdomen and portions of her lower abdomen and chest were also treated with the Er:YAG laser in full ablation mode with the same settings. After 1 year of follow up, there was no recurrence observed. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
Subject(s)
Hyperpigmentation/surgery , Lasers, Gas/therapeutic use , Lasers, Solid-State/therapeutic use , Skin Diseases, Genetic/surgery , Skin Diseases, Papulosquamous/surgery , Adult , Female , HumansSubject(s)
Breast Neoplasms/diagnosis , Carcinoma, Lobular/secondary , Skin Diseases, Papulosquamous/diagnosis , Skin Neoplasms/secondary , Thorax , Aged , Breast/pathology , Breast Neoplasms/pathology , Carcinoma, Lobular/diagnosis , Carcinoma, Lobular/pathology , Dermis/pathology , Epithelial Cells/pathology , Female , Humans , Receptors, Estrogen/analysis , Skin/pathology , Skin Diseases, Papulosquamous/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: Extracorporeal photopheresis (ECP) is commonly performed via peripheral venous access catheter. If this is not possible, a tunneled central venous catheter may be considered. However, this access mode may be associated with high complication rates. Port catheters and permanent arteriovenous fistulas in principle could serve as alternative options; however, treatment opinions are limited. STUDY DESIGN AND METHODS: We report on four adult patients with poor peripheral vein conditions in whom we performed ECP via port catheter. RESULTS: In three of four patients, problems arising from temporarily impaired blood aspiration or reinfusion were solved by repositioning the patient, intermittent flushing of the port catheter, and, in one patient, by instillation of 2500 units of heparin into the port prior to the first ECP of the 2-day cycle. One female patient sustained extensive central venous thrombosis. CONCLUSION: A port catheter may, in certain circumstances, constitute a patient-friendly alternative for venous ECP access when patients' peripheral veins are unsuitable. However, a prolonged ECP procedure duration must be taken into account for decision making.
