Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Telangiectasis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources

Progressive ascending telangiectasia treated with the 585 nm flashlamp-pumped pulsed dye laser.

BACKGROUND AND OBJECTIVE: Progressive ascending telangiectasia (PAT) is a distinct entity with telangiectatic superficial vessels on lower extremities as its main clinical feature. A relationship with occult infections and response to antibiotic and antifungal drugs have been described, although not all cases can be successfully managed with these therapies. Our objective was to treat a woman with PAT that had failed to respond to systemic antibiotic and antifungal drugs. STUDY DESIGN/PATIENTS AND METHODS: A 44-year-old woman with PAT was treated with the flashlamp-pumped pulsed dye laser at 585 nm, with fluences varying from 7 to 7.25 J/cm2. RESULTS: A successful outcome was obtained with this treatment approach, with no relevant adverse effects except for mild pigmentary changes. CONCLUSIONS: Although ectatic vessels on lower extremities are often resistant to dye laser therapy, superficial thin capillaries like those featuring PAT can be eliminated with the pulsed dye laser at 585 nm. Transient pigmentary changes occur on treated areas but they are expected to disappear in 6 to 12 months after treatment. Laser treatment should be considered in PAT despite the extension and location of the lesions.

Adult↗

Leg telangiectasia treatment with a 1.5 ms pulsed dye laser, ice cube cooling of the skin and 595 vs 600 nm: preliminary results.

BACKGROUND AND OBJECTIVE: Preliminary results indicate that pulsed dye lasers (PDL) with 1.5 ms pulsewidth and 595 nm wavelength are effective in the treatment of leg telangiectasia. The aim of this study was to evaluate if the clinical results could be improved by a) an effective skin cooling with ice cubes and b) the longer wavelength of 600 nm. STUDY DESIGN/MATERIALS AND METHODS: In 87 patients with vessels up to 1 mm in diameter, 257 single test treatments were performed using wavelengths of 595 and 600 nm, fluences of 16, 18, and 20 J/cm2, a 1.5 ms pulse duration, and an elliptical spot of 2 x 7 mm. In 7 patients, the skin surface temperature curve was measured after cooling with ice cubes vs hydrogel dressings, and spot geometry and fluence were investigated with and without the gel dressing. RESULTS: Vessel clearance was evaluated 6-8 weeks after treatment. 20 J/cm2 were most effective (80% clearance >50%), and 18 J/cm2 were more effective than 16 J/cm2 (66.2 vs 52.5% clearance >50%). There was a tendency towards better results with 595 nm, but the differences were not significant. Vessels with a diameter <0.5 mm cleared significantly better than those with 0.5-1 mm (69.1 vs 31.9% clearance >50%). Hypo- and hyperpigmentation were seen in 32% of the patients. Cooling with ice cubes proved to be far more effective than with hydrogel dressings (temperature decrease approx 15 vs 5 degrees C). Additionally, the gel dressing caused an energy loss of approx 35% and an irregular spot geometry as shown on burn paper. CONCLUSIONS: Treatment of leg telangiectasia with the 1.5 ms-PDL is safe and effective, especially in vessels smaller than 0.5 mm in diameter; 595 nm and 18 J/cm2 seem to be somewhat more effective as 600 nm and 16 J/cm2; and 20 J/cm2 are even more effective, but persistent hyperpigmentation cannot yet be excluded due to insufficient follow-up time. Cooling with ice cubes is more effective and less expensive than gel dressings, and the short term clinical results are equivalent, even if the frequency of transient pigmentary changes is increased.

Bandages↗

New approaches to the treatment of vascular lesions.

BACKGROUND AND OBJECTIVE: The pulsed dye laser was developed based on the concept of selective photothermolysis. By using a wavelength of light well absorbed by the target and pulse duration short enough to spatially confine thermal injury, specific vascular injury could be produced. STUDY DESIGN/MATERIALS AND METHODS: Although the pulsed dye laser revolutionized the treatment of port wine stains (PWS) and a variety of other vascular lesions, the ideal thermal relaxation time for the vessels in PWS is actually 1-10 ms, not 450 micros of the original pulsed dye laser machines. These original theoretical calculations recently have been proven correct in a study that used both an animal vessel model and in human PWS. RESULTS: Longer wavelengths of light, within the visible spectrum, penetrate more deeply into the skin and are more suitable for deeper vessels, whereas longer pulse durations are required for larger caliber vessels. CONCLUSION: A variety of lasers recently have been developed for the treatment of vascular lesions which incorporate these concepts into their design, including pulsed dye lasers at 1.5 ms, a filtered flash-lamp pulsed light source with pulse durations of 1-20 ms, several 532-nm pulsed lasers with pulse durations of 1 ms to as high as 100 ms, long pulsed alexandrite lasers at 755 nm with pulse durations up to 20 ms, pulsed diode lasers in the 800 to 900 nm range, and long pulsed 1064 Nd:YAG sources.

Humans↗

Treatment of leg telangiectasia by using a long-pulse dye laser at 595 nm with and without dynamic cooling device.

BACKGROUND AND OBJECTIVE: The long-pulse dye laser (PDL) at 595 nm and pulse duration of 1.5 msec has been shown to improve clearance of larger vessels such as those seen in leg telangiectasia. The objectives of this study are twofold. First, to determine the effect of the dynamic cooling device (DCD) in clearance of leg telangiectasia by using a long-pulse PDL at 595 nm. Next, to determine the effect of the DCD in reducing transient discomfort associated with treatment and in reducing epidermal damage (blistering, hyper/hypopigmentation, scarring) caused by the laser. STUDY DESIGN/MATERIALS AND METHODS: Matched treatment sites were compared at energy densities of 20 and 24 J/cm(2) with and without the use of the cryogen spray in 18 patients. In areas treated without the DCD, the laser pulse was delivered through a single layer of Spenco Second Skin. Patients received two treatments 6 weeks apart. Discomfort ratings, clearance of leg telangiectasia, and complications were assessed at 6 weeks, 12 weeks, and 6 months. RESULTS: A reduction in discomfort ratings was found in most patients using the DCD. Six-month follow-up data revealed at the 20 J/cm(2) treatment sites, with or without the DCD, 76.9% showed greater than 50% clearance. At the 24 J/cm(2) treatment sites, with or without the DCD, 84.6% showed greater than 50% clearance. CONCLUSION: The long-pulse dye laser at 595 nm with a 1.5-msec pulse duration cleared leg telangiectasia an average of 67.5% with two treatments at 6 months. The major effect of the DCD was on pain reduction. There was no difference in clearance rates when using the DCD vs. cooled Second Skin. Further studies with longer cooling times with the DCD are needed to optimize treatment parameters.

Adult↗

Cold air in laser therapy: first experiences with a new cooling system.

BACKGROUND AND OBJECTIVE: Analgesic cooling technologies are firmly established in dermatologic laser therapy. We present cold air as a novel method of cooling and compare it with those methods that are already in use. STUDY DESIGN/MATERIALS AND METHODS: We treated 166 patients with the diagnoses hypertrichosis, port wine stains, hemangioma, essential telangiectasias, and tattoos with different laser systems (long-pulsed alexandrite laser [LPIR], pulsed dye laser, Q-switched Nd:YAG laser, Q-switched ruby laser). In a prospective study, we collected data about the analgesia of the cooling method and the thermal protection of the epidermis (reduction of the extent and duration of erythema, purpura, blisters, hyper-/hypopigmentations, edemas, crusting), compared with the cooling method with ice gel. Additionally, we measured air and skin temperatures with an infrared thermometer at different application modalities. RESULTS: Three percent of the treated patients refused the cold air therapy altogether. Eleven percent found that it was as good as the other cooling methods; 86% clearly preferred the cold air therapy. Leaving out the perinasal area, the percentage rises to 97%. On average, the analgesic effect was by 37% better than through cooling with ice gel. The increased thermal protection of the epidermis made it possible to use laser energy levels that were higher by 15-30% and, at the same time, to reduce the rate of side effects (in 63% of the patients erythema persisted for a shorter period, in 70% the purpura was reduced, 83% had less crusting). CONCLUSION: In dermatologic laser therapy, the use of cold air in analgesia can be considered as an effective, inexpensive, and well-accepted (by both patients and doctors) alternative to currently applied cooling methods. Nevertheless, further prospective studies are necessary to determine whether treatment results can really be improved by using higher laser energy levels.

Air↗

Telangiectatic osteogenic sarcoma.

Of approximately 1,999 cases of osteogenic sarcomas at the Mayo Clinic, 25 were diagnosed as telangiectatic osteogenic sarcomas. Of the 25 patients involved, 16 were males and 9 were females, and their ages ranged from 6 to 49 years. Six patients had had pathologic fracture. The lesions were typically located centrally and usually in the distal femur or proximal humerus and roentgenographically were large and purely lytic with destruction of cortex. Grossly, the lesions were cystic and contained clotted blood. Histologically, cystic spaces that contained blood were lined with anaplastic spindle cells and benign giant cells; sometimes, there were so few malignant cells that diagnosis was difficult. Usually, fine, lacelike osteoid was present. Of the 25 patients, 23 have died of metastatic disease, and another has developed pulmonary metastasis 11 months after amputation. Only one patient has survived for more than five years; however, he has developed pneumothorax. Data from this series suggest that the outlook in telangiectatic osteogenic sarcoma is more bleak than in conventional osteosarcoma.

Adolescent↗

Telangiectatic osteogenic sarcoma: a clinicopathologic study of 124 patients.

One hundred-twenty-four patients with this rare and special variant of osteogenic sarcoma were treated at Memorial Sloan-Kettering Cancer Center from 1921 through 1979, representing 11% of all of osteogenic sarcomas. The lesions were predominantly lytic, destructive tumors with only minimal sclerosis on roentgenograms and soft as well as cystic on gross examination. Histologically, aneurysmally dilated spaces lined or traversed by sarcoma cells producing osteoid were noted. The differential diagnosis both radiographically and histologically included several benign lesions like aneurysmal bone cyst and giant cell tumor, among many others. It was found that telangiectatic osteogenic sarcoma is relatively frequent in the femoral diaphysis and in the distal end of the femur. Twenty-nine percent of the patients present with pathologic fracture, or this develops later. Age and sex distribution, or clinical signs or symptoms were those of ordinary osteogenic sarcomas. No differences in survival rates were found in lesions that were purely lytic or those with minimal sclerosis. Similarly, no differences in survival were noted when comparing patients with telangiectatic or ordinary osteogenic sarcoma. As a matter of fact, definite increase in survival was found in patients treated since 1975 with preoperative multidrug chemotherapy employing high-dose methotrexate. Adriamycin, and the combination of bleomycin, cyclophosphamide, and dactinomycin.

Adolescent↗

Telangiectatic osteosarcoma of the mandible.

A telangiectatic variant of osteosarcoma of the mandible was seen in a 15-year-old Chinese girl. It was first diagnosed as an aneurysmal bone cyst both radiologically and pathologically. There were local recurrences despite repeated surgery, and subsequent response to chemotherapy and radiotherapy was poor. The patient died 16 months later with direct cerebral invasion, but no distant metastases. Diagnostic and clinicopathologic correlative aspects of this tumor variant are discussed, but more study of this tumor variant in the jaw is needed because this is probably the first case fully reported.

Adolescent↗

Extraskeletal telangiectatic osteosarcoma.

The first three well-documented cases of pure, extraskeletal telangiectatic osteosarcoma of the soft tissues are presented in this article. The distinctive gross features were a predominance of large, blood-filled spaces, which, on histologic examination, were large blood-filled cavities in association with cyst-like walls containing anaplastic spindle cells and definite osteoid production in two of three cases. One of the cases is of additional clinical interest because the teen-aged daughter of the woman patient had died 1 year previously of a high-grade intramedullary osteosarcoma of bone.

Adult↗

DNA repair defects and chromosome instability disorders.

Xeroderma pigmentosum (XP), Fanconi anaemia (FA), ataxia telangiectasia (AT) and Bloom disease (BS) are four rare autosomal recessive disorders in which there is defective DNA repair and/or chromosome instability and proneness to malignancy. Between 80 and 90% of patients with XP have a defect, demonstrable at cell level, of excision of DNA lesions induced by ultraviolet rays, while the remainder have a cellular error of post-replication repair. XP cells are also deficient in repairing DNA damage caused by a variety of chemical mutagens. There are at least five different complementation groups of the first, or classical, type of XP (A to D, etc.) Apparently group C patients, as well as those with defective post-replication repair, do not show the progressive neurological illness found in a proportion of the other patients. AT is heterogeneous clinically and genetically. Clinically it presents with a progressive neurological illness, progressive telangiectases and a developmental disorder of the thymus. AT is characterized by sensitivity to X-rays and AT cells are unable to repair gamma-ray-induced damage to bases in the DNA. It appears that in many cases of the disorder a chromosomally marked cellular clone is found. In BS the main defect, which results in growth retardation, sun-induced lesions of the face and susceptibility to infection, appears to be a slow DNA chain maturation during DNA synthesis. An increase of sister chromatid exchanges is characteristically seen in the chromosomes of cultured BS cells. In FA, in which there is progressive pancytopenia with eventual bone marrow exhaustion and a tendency to haemorrhage and infection, the cellular defect seems to consist of faulty removal of repair of cross-links in the DNA. In this condition, as in BS and AT, various structural chromosome changes are detected in cultured cells. Patients with XP develop skin cancers in early life and often maligant melanomas. In the other three disorders, in which an immune deficiency is often present, leukaemia and related proliferative disorders are a frequent cause of death while other malignancies also occur. There is some evidence that points to an increased risk of malignancy in heterozygotes who carry the FA and AT genes.

Abnormalities, Multiple↗

X-linked mental retardation and characteristic physical features in two brothers with duplication Xp22-Xpter.

Two brothers are reported who share mental retardation, conjunctival teleangectasias (mainly equatorial) and characteristic flat face with small mouth and thin prolabia. At the neuropsychological examination, the older brother at 14 years showed a full scale IQ of 40 (WISC), with verbal IQ 45 and performance IQ 44. The younger brother at 7 years showed a full scale IQ of 58 (WPPSI), with verbal IQ 67 and performance IQ 55. Chromosome studies showed a duplication Xp22-Xpter in both brothers and in the inactivated X of their mother. The anomaly was not present in a 3rd healthy brother and in other healthy relatives. The mother has normal intelligence and did not present any of the physical features of her affected sons.

Adolescent↗

Association of arrhythmia and sudden death in macrocephaly-cutis marmorata telangiectatica congenita syndrome.

Macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) constitutes a distinct entity characterized by prenatal overgrowth, macrosomia, hemihypertrophy, macrocephaly, nonobstructive hydrocephaly, frontal bossing, hypotonia, developmental delay, generalized or facial capillary malformation with upper philtral nevus flammeus and cutis marmorata, joint hypermobility, loose skin, toe syndactyly, and postaxial polydactyly. All but one of the cases reported previously had benign clinical courses without showing an increased risk of early infant death. We describe three additional cases with poor clinical outcomes including severe postnatal growth failure, intractable cardiac arrhythmia in two cases, and sudden infant death in two cases. Arrhythmia has not been described previously as one of the symptoms of M-CMCT. Patients with M-CMTC associated with severe postnatal growth failure and arrhythmia may constitute a distinct clinical subtype of M-CMTC with an increased risk of life-threatening episodes or sudden death. Recognizing this clinical subtype of M-CMTC is important to prevent these serious potential complications.

Abnormalities, Multiple↗

Macrocephaly-cutis marmorata telangiectatica congenita: seven cases including two with unusual cerebral manifestations.

Macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) is a recently described multiple congenital anomaly/mental retardation (MCA/MR) syndrome of unknown cause. This condition is easily recognizable at birth in children with macrocephaly, cutis marmorata, face and/or body segmental overgrowth, toe syndactyly, midface capillary malformation, and hemimegalencephaly. Cutis marmorata may be absent in some cases. Most patients are developmentally delayed. We describe seven new patients, including two with unusual cerebral manifestations and severe outcome. One of two had a complex congenital heart defect (CHD) and died in the neonatal period. Brain magnetic resonance imaging (MRI) showed generalized cortical dysplasia. The other patient had a stroke episode at age 14 years. Cerebral arteriography showed an abnormal vascular pattern. These findings are consistent with the fact that M-CMTC is a generalized vasculopathy.

Abnormalities, Multiple↗

Macrocephaly-cutis marmorata telangiectatica congenita: report of six new patients and a review.

We report on six additional patients with macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC; MIM 602501) and review the literature. This syndrome is a multiple congenital anomalies/mental retardation and overgrowth disorder comprising macrocephaly, cutis marmorata, vascular marks of lip and/or philtrum, syndactyly, hemihypertrophy, CNS anomalies, and developmental delay. Based on the findings in our 6 patients and on 69 patients previously reported we listed the very frequent (observed in >75%), frequent (25-75%), and less frequent (>25%) components of the syndrome.

Abnormalities, Multiple↗

Genotype-phenotype correlation in hereditary hemorrhagic telangiectasia: mutations and manifestations.

Hereditary hemorrhagic telangiectasia (HHT) is a genetically heterogeneous vascular dysplasia with multiple telangiectases and arteriovenous malformations and it is caused by mutations in endoglin gene (ENG) (HHT1) and activin A receptor type II-like 1 gene (ACVRL1) (HHT2). We evaluated 111 patients with HHT from 34 families by history, examination, screening for vascular malformations, and sequencing of both genes. We found mutations in 26 of the 34 kindreds (76%) analyzed-54% were in ENG and 46% were in ACVRL1. Mutations in ACVRL1 cluster largely in exons 7 and 8, but ENG mutations were widely distributed within that gene. We found that epistaxis had an earlier onset in patients with HHT1 than those with HHT2, but the severity by middle ages was similar. Pulmonary arteriovenous malformations were more frequent and on the average of larger size in HHT1. Hepatic vascular malformations were more common in patients with HHT2. Cerebral arteriovenous malformations were more common in patients with HHT1, but spinal arteriovenous malformations were seen only in patients with HHT2. Truncating mutations in ENG were associated with more affected organs and more severe hemorrhaging than were missense mutations. We conclude that HHT2 has a later onset than HHT1 and the former may disproportionately involve smaller vessels in tissues with more significant vascular remodeling.

Activin Receptors, Type II↗