Angioma Research Articles

Dermatological and Dermoscopic Baselines in BRCA Mutation Carriers.

Breast cancer-associated genes 1 and 2 (BRCA1 and BRCA2) are tumor suppressor genes encoding a large protein that is involved in many essential biological processes. BRCA mutated patients show an increased risk to develop several malignancies, including cutaneous malignancies, although inconsistently across multiple studies. We carried out an observational study on the main dermatological and dermoscopic aspects in a population of patients with BRCA 1/2 mutations, to identify the main clinical and dermoscopical features in this class of patients. A total of 52 patients with BRCA mutations were included in the current analysis. Clinical, dermoscopical, and pathological data were obtained during the dermatologic visits. Out of the entire cohort, 67.3% of patients showed brown hairs and 63.5% of patients showed brown eyes, with phototype III as the most frequent phototype (69.2%). A total of 2.017 melanocytic lesions in all patients were analyzed; specifically, 40 patients (76.9%) showed a total number of nevi > 10, while regarding the main observed dermoscopic features, a prevalence of reticular pattern in 63% of cases was observed, followed by a mixed pattern in 19.2% of cases. Regarding the cutaneous examination, eruptive angiomas (eCAs) were the main dermatologic manifestations in 46.2% of patients. Out of 52 patients and during a follow-up of 24 months one patient developed an in situ melanoma. Interestingly, none of the patients with eCAs showed a TN > 10, highlighting an inverse correlation. To date, there is insufficient evidence to warrant increased surveillance in patients with BRCA mutations or with a positive family history for BRCA mutations, in the absence of standard cutaneous risk factors. Further studies with larger samples of patients are needed to better investigate dermatological and dermatoscopic features in BRCA mutation carriers.

Tufted angioma of the eyelid – A rare entity

Tufted angioma of the eyelid – A rare entity

Dye laser and long-pulsed Nd: YAG laser treatment of vascular lesions: Clinical experience

Introduction: Hemangiomas and vascular malformations are common vascular lesions. Although various methods have been described in the treatment of vascular lesions, the place of lasers is very important. Today, dye laser and Nd: YAG lasers are most commonly used in the laser treatment of vascular lesions. Materials and Methods: A total of 137 patients treated with 585–600 nm flashlamp pulsed dye laser and 1064-nm long-pulsed Nd: YAG laser in three laser units were searched, and laser setups and the number of sessions used were evaluated. Evaluations were made by three plastic surgeons over photographs. According to the discoloration and decrease in height of the lesion, it was classified as 0%–25% (poor), 25–50 (average), 50–75 (good), and 75–100 (excellent). The age of the patients ranged from 2 months to 55 years. 53 port-wine stain, 18 telangiectasia, 8 cherry angioma, 12 spider angioma, 18 hemangioma, 8 venous lake, 11 intraoral hemangioma, and 9 other vascular lesions constituted the distribution of diagnoses between patients. Laser power used in dye laser treatments ranged between 7 and 19 J/cm2, the mean sequence was 6.4, and duration ranged between 1.5 and 20 msec. Nd:YAG l laser power ranged between 120 and 240 J/cm2, the mean sequence was 2.8, and duration ranged between 10 and 50 msec. Results: Seventy patients (51.1%) achieved excellent results, 32 patients (23.36%) achieved good results, 14 patients (10.21%) achieved average clearance, and 21 patients (15.33%) showed low or no removal of their lesion. High success was achieved with minimal complications. Conclusion: Today, dye laser and Nd: YAG lasers provide a satisfactory aesthetic result, low morbidity, and effective treatment for many vascular lesions in terms of patient comfort. In order to optimize results and reduce negative effects, it is necessary to master the properties of the laser and have sufficient knowledge of the interactions of the laser with tissue.

Skin Diseases Classification Using Deep Leaning Methods.

Due to the high incidence of skin tumors, the development of computer aided-diagnosis methods will become a very powerful diagnosis tool for dermatologists. The skin diseases are initially diagnosed visually, through clinical screening and followed in some cases by dermoscopic analysis, biopsy and histopathological examination. Automatic classification of dermatoscopic images is a challenge due to fine-grained variations in lesions. The convolutional neural network (CNN), one of the most powerful deep learning techniques proved to be superior to traditional algorithms. These networks provide the flexibility of extracting discriminatory features from images that preserve the spatial structure and could be developed for region recognition and medical image classification. In this paper we proposed an architecture of CNN to classify skin lesions using only image pixels and diagnosis labels as inputs. We trained and validated the CNN model using a public dataset of 10015 images consisting of 7 types of skin lesions: actinic keratoses and intraepithelial carcinoma/Bowen disease (akiec), basal cell carcinoma (bcc), benign lesions of the keratosis type (solar lentigine/seborrheic keratoses and lichen-planus like keratosis, bkl), dermatofibroma (df), melanoma (mel), melanocytic nevi (nv) and vascular lesions (angiomas, angiokeratomas, pyogenic granulomas and hemorrhages, vasc).

Angiomas at the university hospital of Yalgado Ouedraogo in Ouagadougou, Burkina Faso: Epidemiological and clinical profile.

Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angiomas in the Dermatology-Venerology Department of the University Hospital of Yalgado Ouedraogo in Ouagadougou (Burkina Faso) to contribute to improving knowledge of this group of pathologies in our region. This cross-sectional descriptive, retrospective, and prospective study covers cases from 1998 through 2014. We identified 61 patients with angioma, 67.2% of them younger than 30 months. The sex ratio was 0.56. Vascular tumors (hemangiomas) accounted for 43 cases (70.5%) and vascular malformations 18 (29.5%). Lesions appeared between 0 and 15 days of life in 57.4% of cases. Their size ranged from 1 to 3 cm in 49.2% of cases. They were most frequently located on the head (49.2%). The most frequent clinical forms were cutaneous hemangiomas (tuberous) (36 cases), followed by the nevus flammeus (8 cases), and mixed hemangiomas (7 cases). Only one complex forms was observed: one case of Klippel-Trenaunay syndrome. Superficial vascular abnormalities are rare in our dark skin type context including infantile hemangiomas. The clinical peculiarities of the angiomas observed in this African series in Ouagadougou seem quite similar to the characteristics described in European and American series.

Tufted angiomas: Report of two cases

Tufted angiomas: Report of two cases

Sturge-Weber Syndrome: A Boy with Port-wine Stain and Seizure

Neurocutaneous disorders are a heterogeneous group of genetic disorders that include Sturge-Weber syndrome (SWS), which is characterized by congenital capillary-venous malformation manifesting as port-wine stain, leptomeningeal angiomatosis and ocular angiomas. Diagnosis is made when at least two of these three areas are involved. Abnormal vessels lead to stasis and congestion resulting in decreased regional perfusion and eventually cause hypoxic brain injury with neuronal loss and gliosis. Seizures are common neurological manifestation in SWS patients and many patients have intractable seizures, eventually leading to motor deficits or developmental and cognitive delays. Here we report a case of a 16-year-old boy who presented with typical port-wine stain and seizure disorder since childhood. Neuroimaging revealed evidence of cerebral vascular malformation ipsilateral to the cutaneous lesion. Seizure was controlled with antiepileptic drugs. Early diagnosis and prompt treatment may reduce the incidence of neurologic sequelae. Proper counselling is necessary to improve compliance.

A case of tufted angioma successfully treated by dual-wavelength laser

A case of tufted angioma successfully treated by dual-wavelength laser

Tufted angioma: A picture not to forget

Tufted angioma: A picture not to forget

Sturge-Weber syndrome Case report

Sturge-Weber Syndrome (SWS – encephalotrigeminal angiomatosis) is a rare non-hereditary congenital condition. It develops in the early foetal period, at the stage when the embryo head is being formed, as a result of a random somatic mutation of the GNAQ gene due to unknown reasons. The main symptom is the formation of congenital angiomas, especially in the area of capillaries, in the leptomeninges in the brain, and along the course of the trigeminal nerve. Such angiomas may also be present on lips, and in the whole oral cavity: on its bottom, palate and gingivae. It may lead to serious malocclusions and breathing problems. <b>Aim</b>. This article aims to present problems regarding orthodontic treatment of patients with Sturge-Weber syndrome, using an example of a 7-year-old female patient.<b> Case report</b>. A 7-year-old girl with all signs of this syndrome, namely glaucoma, epilepsy, neurological disorders, cutis marmorata telangiectatica congenita and after sanitation of the oral cavity, had hygiene procedures and exercises with a vestibul plate introduced. Two attempts to take impressions for appliances failed due to patient’s anxiety reactions. <b>Conclusions</b>. This case shows difficulties that may be faced by an orthodontist when treating patients with Sturge-Weber syndrome. In this case, namely type I in the Roach scale, due to neurological disorders it was necessary to take special precautions in relation to procedures introduced and to avoid stress in a patient. It makes orthodontic treatment difficult.<b> (Witanowska J, Laskowska M, Zadurska M. Sturge-Weber syndrome. Case report. Orthod Forum 2018; 14: 143-9)</b>.

Recent advances in the diagnosis and treatment of Kasabach-Merritt phenomenon

Kasabach - Merritt phenomenon(KMP), also known as Kasabach - Merritt syndrome, is a rare syndrome associated with Kaposiform haemangioendothelioma or tufted angioma, and characterized by thrombocytopenia and consumptive coagulopathy.KMP onsets early and progresses quickly.If diagnosis and treatment delayed, it can be life-threatening.In this paper, the progress of clinical manifestations, pathogenesis, diagnosis and treatment of KMP are summarized. Key words: Kasabach-Merritt phenomenon; Kaposiform hemangioendothelioma; Tufted angioma; Child

Tufted angioma

Tufted angioma

Diagnosis and treatment for littoral cell angioma: report of 9 cases

Diagnosis and treatment for littoral cell angioma: report of 9 cases

Magnetoencephalography and magnetic source imaging studies for epilepsy associated with Sturge-Weber syndrome

Objective To study the characteristics, influence factor and clinical value of magnetoencephalography (MEG)in patients of epilepsy associated with Sturge-Weber syndrome. Methods A retrospective study was conducted at Magnetoencephalography Laboratory of Sanbo Brain Hospital, Capital Medical University. Fourteen patients of epilepsy associated with Sturge-Weber syndrome were enrolled into the study between October 2010 and June 2016. The following data were analyzed including the results of MEG with Long-term video-EEG (scalp) monitoring and preoperative MRI in all patients. Results In 8 out of 14 cases, the background activities of MEG were weakened. Epileptiform discharges were detected in 11 cases including 9 cases with epileptogenic zone on ipsilateral side of intracranial lesion (angioma, 6 cases on the right side and 3 cases on the left side) and 2 cases with bilateral epileptogenic zones. Both interictal EEG and MEG detected epileptiform discharges in 9 out of 14 cases. Epileptiform discharges were observed in 2 cases by MEG only and in 1 case by EEG only. Neither MEG or EEG detected any epileptiform discharges in 2 cases. Conclusions The interictal results of MEG seem similar to those of EEG in cases of Sturge-Weber syndrome, which mainly include weakening of background activities and epileptiform discharges commonly on ipsilateral side of brain lesion and rarely on both sides or contralateral hemisphere. The magnetic source imaging technology combining MEG and MRI could help localize the epileptogenic zone in Sturge-Weber syndrome. Key words: Sturge-Weber syndrome; Epilepsy; Magnetoencephalography; Magnetic source imaging

Dual-wavelength pulsed dye laser for the treatment of spider angioma in children: an observational clinical study

Objective To evaluate the clinical efficacy and adverse effect of dual-wavelength pulsed dye laser for the treatment of spider angioma in children, and to observe recurrence of spider angioma after treatment with it. Methods A dual-wavelength approach with 585-nm and 1 064-nm pulsed-dye lasers was used to treat 233 children with spider angioma, who were followed up for at least 6 months. Correlations of the clinical efficacy with disease duration, skin complexion, age, gender and so on were analyzed, and adverse reactions and recurrence were evaluated. Results The clinical efficacy of the dual-wavelength pulsed dye laser was good in the treatment of spider angioma in children, with the recovery rate and response rate being 87.1% and 100% respectively, and was negatively correlated with the disease duration. There was no significant difference in the clinical efficacy among children with different skin complexions, but treatment sessions for recovery increased in children with Fitzpatrick skin type Ⅳ compared with those with Fitzpatrick skin type Ⅲ. Additionally, no significant difference in the clinical efficacy was observed among children of different age and gender. After the laser treatment, purpura, blisters and swelling occurred instantly, hyperpigmentation and hypopigmentation occurred in a short-term period, and no obvious long-term adverse reactions were observed. Of 233 children, 21 (9.4%) experienced recurrence between 6 months and 2 years after the laser treatment, with a mean recurrence interval of 7.3 ± 3.4 months. Conclusion The dual-wavelength pulsed dye laser is effective and safe for the treatment of spider angioma, and can serve as the first-line therapeutic method for childhood spider angioma. Key words: Telangiectasis; Child; Lasers, dye; Spider veins; Pulsed dye laser

Experience of 243 cases in transperitoneal robotic-assisted laparoscopic surgery for adrenal diseases

Objective To summarize our experience in robotic-assisted laparoscopic surgery for adrenal diseases Methods The clinical data of 243 patients with adrenal tumor treated by robotic-assisted laparoscopic surgery from March 2010 to February 2017 were retrospectively reviewed. There were 99 men and 144 women. The mean age was 51.6 years (range, 19-84). Tumors located at left adrenal in 140 cases , right in 97 cases, and both sides in 6 cases. The average diameter was 3.32 cm (range, 0.8-12 cm). However, there were 41 cases whose tumor diameter were greater than 5 cm. Results There were 2 cases of conversion during operation, 1 case converted to open surgery and the other to the traditional laparoscope surgery. The mean operative time was 35 min (range, 20-130 min). Estimated blood loss was 80 ml (range, 20-1 200 ml). Blood transfusion was needed in 6 cases. The mean postoperative hospital stay was 5d (range, 3-20 d). The pathological diagnosis included 37 cases of pheochromocytoma, 149 cases of cortical adenoma, 3 cases of cortical carcinoma, 5 cases of metastatic tumor, 9 cases of adrenal myelolipoma, 3 cases of adrenal cyst, 2 cases of bronchogenic cyst, 25 cases of adrenal nodular hyperplasia, 2 cases of angiomyolipomas, 1 case of mature teratoma, 1case of diffuse large B-Cell lymphoma, 1 case of angioma, and 4 cases of neurofibromatosis. Conclusions Robotic-assisted laparoscopic adrenalectomy was safe and effective. Robotic-assisted laparoscopic surgery has the advantages over laparoscopic surgery in treatment of complicated adrenal tumor, such as large adrenal tumors, pheochromocytoma, bilateral adrenal diseases, overweight and obese patients with adrenal diseases. Key words: Adrenal tumor; Robotic; Laparoscopic; Adrenalectomy

Diagnosis and management of spinal epidural dumbbell-shaped cavernous vascular malformation

Objective To investigate the patterns of clinical manifestations, diagnosis, treatment and surgical outcomes of spinal epidural dumbbell-shaped cavernous hemangiomas. Methods Between June 2008 and November 2013, a series of 9 patients with symptomatic spinal epidural dumbbell-shaped cavernous hemangiomas were surgically managed in Beijing Tiantan Hospital, in which the diagnoses were pathologically verified. The clinical manifestations, radiographic features, treatment modality and prognosis were retrospectively reviewed. The attention was specially paid to the differential diagnosis for other lesions that mimicking a dumbbell-shaped tumors. Results Among the 9 cases, 6 were male and 3 were female.The mean age at presentation was 58±12 years (range 34-79 years) The tumor locations included thoracic levels in 7 cases, cervical levels in 1 case and cervicothoracic junction in 1 case). Except two recurrent cases and one with acute onset, were the others demonstrated chronically progressive features. The initial diagnoses included schwannoma in 6 patients, cavernous hemangiomas in 1 case, meningioma in 1 case and angioma in 1 case.Complete resection was achieved in 7 patients, and partial resection was performed in the other 2 patients .The average volume of intraoperative blood loss measured 400±300 ml, ranging from 100 ml to 1 000 ml. None of the cases developed surgical complications. The follow-up lasted an average of 71±21 months (range 29-94 months), which demonstrated that significant improvement was achieved in 7 out of 9 cases, no significant symptom relief was reported in 1 case, and symptomatic worsening occurred in 1 case. one partially improved, and one worsened during follow-up. Conclusions The spinal epidural dumbbell-shaped cavernous hemangioma is relatively uncommon and thus easily misdiagnosed. Microsurgical operations seem to demonstrate relative safety and good outcomes. Key words: Spinal cord; Epidural space; Hemangioma, cavernous, central nervous system; Dumbbell-shaped; Disease attributes

Multiple Intramedullary Cavernous Angioma of the Cervicothoracic Spine: Case Report and Review of the Literature

Intramedullary cavernous angioma (ImCA), which was originally thought to be an uncommon vascular lesion, has shown an increased incidence since the advent of magnetic resonance imaging. We present a case of multiple ImCAs in the cervicothoracic region. The patient presented with slow, progressive motor weakness in the upper and lower limbs. Surgical intervention was performed because of misdiagnosis as a spinal cord tumor. The patient underwent decompression surgery because no neoplasm was noted in the course of the operation. The angioma regressed on follow-up magnetic resonance images 3 months later.

Pregnancy complicated with intracranial cavernous angioma: one case report

Pregnancy complicated with intracranial cavernous angioma: one case report

A brief discussion on relationship among spider angioma, liver cirrhosin and hepatopulmonary syndrome

A brief discussion on relationship among spider angioma, liver cirrhosin and hepatopulmonary syndrome