Vascular lesions in genital lichen sclerosus in pediatric patients

2020 ◽  
Vol 37 (5) ◽  
pp. 849-852
Author(s):  
Rivka Friedland ◽  
Dan Ben‐Amitai ◽  
Elena Didkovsky ◽  
Meora Feinmesser ◽  
Alex Zvulunov
2006 ◽  
Vol 10 (3) ◽  
pp. 151-153 ◽  
Author(s):  
F. Sule Afsar ◽  
Ragıp Ortac

Background: Acquired port-wine stains (PWSs) are vascular lesions that are identical to congenital PWSs morphologically and histopathologically. Objective: Because acquired PWSs are rarely seen in adult and pediatric patients, we present a 9-year-old boy with an acquired PWS on his left forearm. Conclusion: None of the proposed etiologies, such as trauma, chronic sun exposure, or hormonal medication, was applicable to our patient, and a literature review showed us that acquired PWSs give a faster and better response to pulsed dye laser therapy than congenital lesions do.


1993 ◽  
Vol 16 (5_suppl) ◽  
pp. 165-167 ◽  
Author(s):  
N. Scarpato ◽  
C. Falco ◽  
G. Nappi ◽  
S. Formisano

The Authors consider problems related to technique and organization of LDL-Apher-esis with respect to some particular aspects. They evaluate: a) Technical complexity of procedures both in devices to use and in staff preparation; b) Length of treatment which conditions the other fields of activity; c) Problems in management treatments periodicity; d) Usually high cost of this kind of procedures; e) Problems related to vascular accesses; f) Problems related to pediatric patients, both for their low weight and vascular accesses; g) Management of cardiovascular complications; h) Difficulties in evaluation of regression of vascular lesions. Finally, it is particularly difficult the management of psychological aspects related to somatic symptoms of the disease and to the acceptance of treatment.


2020 ◽  
Author(s):  
Michele Troutman ◽  
Hong-Thao Thieu

Vulvar lesions are a common complaint for which pediatric patients seek medical attention. Please refer to the chapter on Prepubertal Vulvovaginitis for more details. A careful history and physical exam, including full skin exam should be performed when pediatric and adolescent patients present with vulvar complaints. The chief complaint and chronicity of the symptoms can narrow the differential. The chronicity and areas of dermatologic involvement can also be key to diagnosing a systemic condition versus a primary vulvar dermatosis. When the latter is assumed, a referral to an appropriate specialist such as a Pediatric and Adolescent Gynecologist or Dermatologist should be considered. Treatment for vulvar dermatoses should be etiology dependent with consideration of systemic treatment as appropriately indicated. Vulvar hygiene should be considered in all patients as restoring the skin barrier and removing potential irritants is imperative to healing and preventing further irritation. This review contains 1 figure, 2 tables, and 25 references. Keywords: vulva, vulva dermatosis, vulvovaginitis, lichen sclerosus, atopic dermatitis, psoriasis, streptococcus vulvovaginitis, irritant dermatitis, contact dermatitis


2011 ◽  
Vol 8 (5) ◽  
pp. 522-525 ◽  
Author(s):  
Michael Hugelshofer ◽  
Nicola Acciarri ◽  
Ulrich Sure ◽  
Dimitrios Georgiadis ◽  
Ralf W. Baumgartner ◽  
...  

Object Cerebral cavernous malformations (CCMs) are common vascular lesions in the brain, affecting approximately 0.5% of the population and representing 10%–20% of all cerebral vascular lesions. One-quarter of all CCMs affect pediatric patients, and CCMs are reported as one of the main causes of brain hemorrhage in this age group. Symptoms include epileptic seizures, headache, and focal neurological deficits. Patients with symptomatic CCMs can be treated either conservatively or with resection if lesions cause medically refractory epilepsy or other persistent symptoms. Methods The authors retrospectively analyzed 79 pediatric patients (41 boys and 38 girls) from 3 different centers, who were surgically treated for their symptomatic CCMs between 1974 and 2004. The mean age of the children at first manifestation was 9.7 years, and the mean age at operation was 11.3 years. The main goal was to compare the clinical outcomes with respect to the location of the lesion of children who preoperatively suffered from epileptic seizures. Results Of these patients, 77.3% were seizure free (Engel Class I) after the resection of the CCM. Significant differences in the outcome between children who harbored CCMs at different locations were not found. Conclusions Resection seems to be the favorable treatment of symptomatic CCMs not only in adults but also in children.


2016 ◽  
Vol 6 ◽  
pp. 2 ◽  
Author(s):  
Anand Alurkar ◽  
Lakshmi Sudha Prasanna Karanam ◽  
Suresh Nayak ◽  
Rajesh Kumar Ghanta

Pial arteriovenous fistulae (AVF) are rare vascular lesions comprising single or multiple arterial feeders draining directly into the venous channel without intervening tangle of blood vessels as in brain AV malformations. In our present paper, we describe three cases of pial AVF in the pediatric age group with different presentations treated successfully with endovascular and surgical methods. Two patients underwent treatment for pial AVF by the endovascular technique and one by surgical clipping. The treatments were successful with good clinical outcome. We did not encounter any peri-procedural complications in any of the cases. Pial AVF is a rare entity and high degree of suspicion and adequate clinical and imaging knowledge is required to make the diagnosis. Exclusion of the fistula from the cerebral circulation should be done at the earliest to prevent devastating complications that result during the natural course of the disease.


Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 933
Author(s):  
Tu Ngoc Vu ◽  
Son Hong Duy Phung ◽  
Long Hoang Vo ◽  
Uoc Huu Nguyen

(1) Background: This study aims to describe the clinical and paraclinical characteristics of and the diagnostic approach to brachial artery injuries in pediatric supracondylar humerus fractures, as well as to evaluate intraoperative vascular anatomical lesions and early postoperative results. (2) Methods: A retrospective, hospital-based analysis of medical records at Viet Duc University Hospital (Vietnam), using a sample of children under 16 years who met the diagnostic criteria for supracondylar humerus fractures with brachial artery injuries between January 2016 and December 2020, was performed. A total of 50 patients were included in the analysis. (3) Results: Out of 50 pediatric patients, 36 patients were male (72%) and the mean age was 5.85 years (range, 1.5–14 years). Before treatment, there were 46 patients with severely displaced fractures which were classified as Gartland type III (92%). Following casting, the percentage of those with severely displaced fractures was reduced significantly to 12%, while there were no patients with Gartland type III fractures after percutaneous pinning. Doppler sonography failed to assess vascular lesions at the fracture site before and after casting in most patients. Two-thirds of surgical cases had only vasospasm, without physical damage to the vessel wall or intravascular thrombosis. Preoperative Doppler spectrum analysis was not consistent with the severity of intraoperative brachial artery injury. Out of 24 patients with vasospasm, we performed vascular blockade using papaverin in 11 cases and intraoperative balloon angioplasty of the brachial artery using the Fogarty catheter in 13 cases. Brachial artery graft was performed with 12 patients who had anatomical damage to the vascular wall. A complication of embolism occurred in one patient immediately after surgery, and two patients had superficial infections. One month following surgery, 2 out of 36 patients had a temporary loss of sensation in the area of incision. (4) Conclusions: Most pediatric patients did not present with symptoms of critical limb ischemia similar to those associated with lower extremity vascular injuries. The diagnosis and treatment of pediatric supracondylar humerus fractures with vascular injury is difficult and time-consuming, especially in cases of transverse fractures.


2020 ◽  
Author(s):  
Michele Troutman ◽  
Hong-Thao Thieu

Vulvar lesions are a common complaint for which pediatric patients seek medical attention. Please refer to the chapter on Prepubertal Vulvovaginitis for more details. A careful history and physical exam, including full skin exam should be performed when pediatric and adolescent patients present with vulvar complaints. The chief complaint and chronicity of the symptoms can narrow the differential. The chronicity and areas of dermatologic involvement can also be key to diagnosing a systemic condition versus a primary vulvar dermatosis. When the latter is assumed, a referral to an appropriate specialist such as a Pediatric and Adolescent Gynecologist or Dermatologist should be considered. Treatment for vulvar dermatoses should be etiology dependent with consideration of systemic treatment as appropriately indicated. Vulvar hygiene should be considered in all patients as restoring the skin barrier and removing potential irritants is imperative to healing and preventing further irritation. This review contains 1 figure, 2 tables, and 25 references. Keywords: vulva, vulva dermatosis, vulvovaginitis, lichen sclerosus, atopic dermatitis, psoriasis, streptococcus vulvovaginitis, irritant dermatitis, contact dermatitis


2019 ◽  
Vol 8 (1) ◽  
pp. 35-44 ◽  
Author(s):  
N. Y. Gorbatova ◽  
T. Y. Yushina ◽  
O. O. Sarukhanyan ◽  
A. G. Dorofeyev ◽  
A. V. Bryantsev

BACKGROUNDBenign vascular lesions of the skin, hemangiomas and pyogenic granulomas are quite common in pediatric patients, which are complicated with bleeding in 7.5% of cases.MATERIAL AND METHODSIn 2016–2018, 17 children with cavernous hemangiomas and pyogenic granulomas complicated with bleeding were operated on an emergency basis at the Research Institute of Emergency Children’s Surgery and Traumatology. Surgical intervention for all patients was performed using the method of interstitial selective laser photodestruction developed by the RIECST, which took out the utility patent. This method was implemented using two wave laser surgical device IPG “IRE-Polus” (Russia), generating two wavelengths of laser radiation of 0.97 μm and 1.56 μm.RESULTSThe analysis of the long-term results of treatment in 17 pediatric patients who were operated on an emergency basis for hemangioma and pyogenic granuloma complicated by bleeding showed that all 17 patients (100%) had a good clinical and aesthetic result. The method of interstitial selective laser photodestruction provided a radical removal with guaranteed hemostasis of the indicated benign vascular lesions of the skin complicated with bleeding illustrate the effectiveness of this method in clinical practice, as well as the possibility of its use in inpatient and outpatient conditions.CONCLUSIONTo prevent the large blood loss in hemangiomas complicated by bleeding and pyogenic granulomas of the skin in children, emergency surgical treatment has been performed using interstitial selective laser photodestruction. This method ensures the radical photodestruction of tissues of a pathological vascular formation and reliable hemostasis, which guarantees the achievement of a good clinical and aesthetic result of treatment in inpatient and outpatient conditions in all cases.


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