Biomedical subjects
M B Maessen-Visch
Publications and source records attributed to M B Maessen-Visch.
The prevalence of factor V Leiden mutation in patients with leg ulcers and venous insufficiency.
OBJECTIVES: To study the prevalence of factor V Leiden mutation in patients with chronic venous insufficiency and venous leg ulcers, compared with a control group, and to find out whether factor V Leiden mutation is more frequent in patients with chronic venous insufficiency and a history of deep venous thrombosis. DESIGN: A case control study. SETTING: Three outpatient dermatological clinics. PATIENTS: Ninety-two patients (37 men, 55 women) with venous leg ulcers and 53 control patients (23 men, 30 women). MAIN OUTCOME MEASURE: Factor V Leiden mutation. RESULTS: Factor V Leiden mutation was significantly more frequent in patients with chronic venous insufficiency and venous leg ulcers than in the control group (23% vs 7.5%; P=.03), and the patients with factor V Leiden mutation were more likely to have a history of venous thromboembolism (91% vs 48%, P=.002). Also, recurrent deep venous thrombosis (38% vs 14%) and recurrent leg ulcerations (9 episodes or more) occurred more frequently in the patients with factor V Leiden mutation (43% vs 19%, P=.01). No difference was observed in venous refill time or in the presence of dermatoliposclerosis and atrophie blanche. CONCLUSIONS: Factor V Leiden mutation is more frequent in patients with venous leg ulceration than in the control group and the general population. Patients with factor V Leiden mutation have an increased risk of developing deep venous thrombosis and recurrent leg ulceration.
[Plastic surgery as a last resort in lichen sclerosus].
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Melanosis naeviformis of Becker and scoliosis: a coincidence?
Melanosis naeviformis of Becker (MNB) can be associated with hypoplasia of soft tissue or extremities, spina bifida and scoliosis of the vertebral column. We have investigated 50 patients (42 men, 8 women) with MNB radiologically. Scoliosis was diagnosed in 13 patients (26%). The curves of scoliosis varied from 11 degrees to 17 degrees. Physical examination revealed no gross asymmetries of the trunk, extremities or breasts. No correlation was seen between the age of patients and the scoliotic curve. In one family the father and oldest son had MNB with scoliosis and the other son and daughter had MNB without scoliosis. Since only mild scoliosis is found in patients with MNB, X-ray examination of the vertebral column has no therapeutic consequences.