Endovenous and perivenous 808-nm laser treatment of lower limb collateral, reticular and telangiectasiac veins.

BACKGROUND: Visible leg veins are not only a mere aesthetic problem, but may also be manifestation of altered microcirculation and superficial venous incompetency. Sclerotherapy is the first-line treatment for leg veins < 4 mm, but it often needs multiple sessions and sometimes fails. The main limitations of transcutaneous laser treatment are the diameter and the depth of the veins: the greater, the harder photothermolysis is, so that higher powers may lead to aesthetic complications. MATERIALS AND METHODS: We report our experience in the treatment of small collateral (< 4 mm), reticular and telangiectasiac veins with endovenous and perivenous 808-nm laser. RESULTS: Overall, 325 treatments were performed on 113 patients. The endovenous and perivenous treatment proved to be a safe, quick, well-tolerated and effective procedure. It ensured an optimal closure of the target veins right from the first treatment in most patients. Sometimes, a second treatment of the same vein was needed. CONCLUSIONS: The endovenous and perivenous 808-nm laser photothermal sclerosis ensures a quick coagulation-fibrosis of the veins of the lower limbs, thus allowing rapid healing and good aesthetic results (stable in 95% of patients after an average follow-up of 18 months). It may be an effective alternative to sclerotherapy.

Livedo reticular associado com Anemia Hemolítica Autoimune: remissão prolongada induzida pelo Transplante de Células-Tronco do Sangue Periférico com recaída após 10 anos e restauração dos níveis de hemoglobina por rituximabe / Livedo reticularis associated with autoimmune hemolytic anemia: prolonged remission induced by peripheral blood stem cell transplantation relapse after 10 years and restoration of hemoglobin levels by rituximab

A anemia hemolítica autoimune (AHAI) é uma doença na qual são produzidos anticorpos diretamente contra as glicoproteínas adsorvidas na superfície da membrana dos eritrócitos. Algumas medicações e outras associações têm sido implicadas. Descrevemos e discutimos um caso de livedo reticular associado à AHAI tratado com transplante de células-tronco de sangue periférico (TCTSP) e que entrou em total remissão por 10 anos. Após esse período, a paciente apresentou recaída, foi tratada com anticorpo anti-CD20 (rituximabe), e atualmente encontra-se em total remissão. O papel do TCTSP e o uso de rituximabe no tratamento de AHAI serão discutidos neste relato de caso.

Autoimmune hemolytic anemia (AIHA) is a disease where patients produce antibodies against erythrocytes directed towards membrane glycoproteins adsorbed onto the erythrocyte surface. Drugs and other associations have been implicated. It is described and discussed a case of livedo reticularis associated with AIHA treated with peripheral blood stem cell transplantation (PBSCT) that went into full remission for 10 years. After that period the patient relapsed and was treated with antibody anti-CD20, rituximab, and is now in full remission. The role of PBSCT and rituximab in the treatment of AIHA will be discussed.

Livedo reticularis associated with autoimmune hemolytic anemia: prolonged remission induced by peripheral blood stem cell transplantation relapse after 10 years and restoration of hemoglobin levels by rituximab.

Autoimmune hemolytic anemia (AIHA) is a disease where patients produce antibodies against erythrocytes directed towards membrane glycoproteins adsorbed onto the erythrocyte surface. Drugs and other associations have been implicated. It is described and discussed a case of livedo reticularis associated with AIHA treated with peripheral blood stem cell transplantation (PBSCT) that went into full remission for 10 years. After that period the patient relapsed and was treated with antibody anti-CD20, rituximab, and is now in full remission. The role of PBSCT and rituximab in the treatment of AIHA will be discussed.