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At least 1,009 records · Page 56Linked to original sources
PubMed1991

A clinical and histopathologic study of granulomatous rosacea.

A retrospective clinical and histopathologic study of 53 patients with granulomatous rosacea was undertaken. The patients had a broad clinical spectrum of lesions that ranged from primarily erythema to papulonodular lesions. Extrafacial lesions occurred in 15% of patients. Histologic examination showed mixed lymphohistiocytic inflammation (primarily lymphocytic inflammation in 40% of patients and primarily histiocytic with a few giant cells in 34%), epithelioid granulomas in 11% of patients, and epithelioid granulomas with caseation necrosis in 11%. Most patients had a good response to oral antibiotic therapy. Granulomatous rosacea is not a distinct disease but can be regarded and treated as a subtype of rosacea.

Aged↗
PubMed1992

Treatment of telangiectases and other benign vascular lesions with the 577 nm pulsed dye laser.

BACKGROUND: This study was undertaken to evaluate the effectiveness and safety of the 577 nm pulsed dye laser in the treatment of various vascular lesions of the face. OBJECTIVE: Our purpose was to make observations on the effects of different variables that could affect response. METHODS: Ninety-two adults with telangiectases of the face were sequentially selected for treatment according to a protocol previously established. Evaluation consisted of visual inspection by two investigators, and before and after photographs at 2-months intervals. A few patients with other vascular lesions were also treated and reported. RESULTS: Ninety-one percent of the patients (84 of 92) showed good to excellent response after a single treatment. Recurrence occurred in 2%. Atrophy of the skin occurred in 2%. Venous lakes, pyogenic granulomas, and mucosal vascular malformations showed significant improvement. CONCLUSION: The 577 nm pulsed dye laser is effective and safe for vascular lesions of the face.

Adult↗
PubMed1993

Focal dermal hypoplasia: four cases with widely varying presentations.

We describe four patients with focal dermal hypoplasia (FDH): a girl with classic FDH, a boy with cutaneous findings, an infant with severe multisystem disease, and the infant's mother, who had previously undiagnosed FDH. These patients illustrate the classic cutaneous manifestations of FDH and the variations that can exist within a family.

Adipose Tissue↗
PubMed1993

Comparison of the local and systemic side effects of methylprednisolone aceponate and mometasone furoate applied as ointments with equal antiinflammatory activity.

BACKGROUND: The therapy for skin diseases with topical glucocorticoids is limited by their local and systemic side effects. A glucocorticoid with an improved benefit-to-risk ratio is desirable. OBJECTIVE: A new topical corticoid, methylprednisolone aceponate (MPA) 0.1% ointment, was compared with the same formulation of mometasone furoate. METHODS: The two ointments were compared with respect to suppression of UVB light-induced erythema (n = 20) and with respect to atrophogenicity and appearance of telangiectasia (n = 20) in two double-blind trials with intraindividual comparisons in healthy volunteers. In a third trial, serum cortisol levels were measured in volunteers receiving extensive (60% of body surface) cutaneous application of MPA (n = 10) or mometasone furoate (n = 11). RESULTS: MPA and mometasone furoate were equally effective in suppressing UVB light-induced erythema. Atrophogenicity, as well as the incidence and severity of telangiectasia, were significantly more pronounced with mometasone furoate than with MPA. Both ointments decreased serum cortisol levels and did not differ significantly in this respect. However, the incidence of serum cortisol level suppression was higher in the mometasone furoate group than in the MPA group. CONCLUSION: MPA ointment has equal antiinflammatory activity and similar cortisol suppression but significantly fewer local side effects than mometasone furoate.

Administration, Topical↗
PubMed1995

Cutaneous telangiectases in neonatal lupus erythematosus.

BACKGROUND: Persistent telangiectases are a feature of neonatal lupus erythematosus (NLE) but have generally been noted in areas of prior inflammatory disease. The occurrence of vascular macules and papules at sites without preceding dermatitis has not been reported in NLE. OBJECTIVE: Our purpose was to emphasize a previously unidentified aspect of cutaneous NLE: the presence of angiomatous or matlike telangiectases in sites without antecedent or concurrent dermatitis. METHODS: We describe seven patients in which telangiectatic macules or angiomatous papules were primary or early features of NLE. RESULTS: Five infants lacked a history of preceding or concurrent inflammatory lesions at sites of telangiectasia development. In four infants findings included vulvar or inguinal angiomatous papules. CONCLUSION: Telangiectases may be a presenting feature of NLE, can be found in sun-protected sites, and may occur independent of "lupus dermatitis."

Child, Preschool↗
PubMed1995

Adverse effects associated with the 577- and 585-nanometer pulsed dye laser in the treatment of cutaneous vascular lesions: a study of 500 patients.

BACKGROUND: The flashlamp-pumped pulsed dye laser has been used in the treatment of cutaneous vascular disorders since 1986. Although this laser is now widely used for the treatment of port-wine stains, telangiectases, and hemangiomas, the incidence of adverse reactions has not been clearly defined in a large series of patients. OBJECTIVE: We assessed the incidence of adverse effects associated with the use of the pulsed dye laser in the treatment of vascular lesions. METHODS: We studied 500 patients undergoing pulsed dye laser treatments for port-wine stains, telangiectases, and hemangiomas. All patients were examined during the course of their treatment to assess the incidence of adverse effects associated with the use of the pulsed dye laser. RESULTS: There were no cases of hypertrophic scarring. The incidence of atrophic scarring was less than 0.1%. A spongiotic dermatitis was seen in 11 of 297 patients (0.04%) after multiple treatments of port-wine stains. Hyperpigmentation was seen in five of 500 patients (1%), whereas transient hypopigmentation was seen in 13 (2.6%). CONCLUSION: These findings demonstrate that the flashlamp-pumped pulsed dye laser is safe for the treatment of port-wine stains, telangiectases, and hemangiomas in children and adults.

Adolescent↗
PubMed1989

Angiodysplasia as a cause of iron deficiency anaemia.

Angiodysplasia, a condition of unknown aetiology, is thought to represent the commonest cause of obscure gastrointestinal bleeding, particularly in the elderly population. The lesions of angiodysplasia, which are small (less than 5 mm) and usually multiple, consist of microvascular abnormalities in the mucosa and submucosa of the bowel wall. They are most commonly found in the caecum and right side of the colon, but have been observed in the stomach, ileum and elsewhere in the colon. The diagnosis is made by either selective visceral angiography and/or colonoscopy, but the lesions cannot be detected on barium studies or with the naked eye at laparotomy. Localisation of the abnormalities by the histopathologist is greatly facilitated by special injection techniques demonstrating the blood vessels of resected colonic specimens prior to fixation and section. Treatment may be conservative (iron replacement) if the anaemia is not severe, by endoscopic fulguration or by colonic resection. Other common causes of gastrointestinal blood loss should always be excluded before the final diagnosis of angiodysplasia is accepted. Although the condition is well recognised as a significant cause of gastrointestinal blood loss a number of questions remain to be answered. The true incidence of angiodysplasia in the population is not known, the aetiology of the condition remains a mystery, although many theories abound.

Aged↗
PubMed1984

The influence of fraction size in radiotherapy on the late normal tissue reaction--I: Comparison of the effects of daily and once-a-week fractionation on human skin.

A comparison of the normal tissue reactions to daily and once-a-week fractionation was performed on postoperatively irradiated bilateral parasternal fields in patients with breast cancer. Both schedules resulted in identical acute skin erythema and pigmentation. However, the development of telangiectasia was significantly more pronounced after once-a-week fractionation. These findings imply that the Cumulative Radiation Effect (CRE) formula has to be modified. The slope of the iso-effect dose versus number of fractions was 0.24 for acute skin reactions and estimated to be about 0.34 for late skin reactions at a dose level equivalent to 46 Gy in 2 Gy fractions with conventional fractionation. The beta/alpha ratio was 0.12 Gy-1 for acute and about 0.31 Gy-1 for late effects, for 200 kV X rays.

Breast Neoplasms↗
PubMed1984

The influence of fraction size in radiotherapy on the late normal tissue reaction--II: Comparison of the effects of daily and twice-a-week fractionation on human skin.

A comparison of the normal tissue reactions to daily and twice-a-week fractionation over 4 to 6 weeks was performed on postoperatively irradiated parasternal fields in patients with breast cancer. The radiation used was electron beams at 12-13 MeV. We have previously reported that the overall treatment time was of importance for establishment of iso-effect relationships for the acute skin erythema. In this paper we present the degree of telangiectasia after 5 years. Generally, a more pronounced late reaction was found after twice-a-week fractionation than was predicted from the acute reactions. The findings imply that the cumulative radiation effect (CRE) formula has to be modified for both acute and late reactions in certain clinical situations. The main conclusion is that the iso-effect relationship varies significantly over the dose range used in clinical radiotherapy. In the dose range of 30 fractions between 1.6 and 2.1 Gy in 6 weeks, the slope of the curve for iso-effect dose versus number of fractions varies between 0.26 and 0.35, the beta/alpha-ratios between 0.22 and 0.37 Gy-1 and the RBE 2 Fractions/week/5 Fractions/week between 1.97 and 1.82.

Breast Neoplasms↗
PubMed1986

The predictive value of skin telangiectasia for late radiation effects in different normal tissues.

Alterations in the microcirculation and parenchymal cell loss are common phenomena after irradiation of different organs. Whether parenchymal cell loss is a process well dissociated from vasculoconnective damage, or a consequence of this, is much debated. However, comprehensive radiopathological studies have shown that vasculoconnective tissue is an important common target for late effects in various organs. Scoring of skin telangiectasia was used by us as a clinical assay of late tissue effects after different dose schedules. All studies were done prospectively with standardized skin area, field size and radiation quality. The patients were scored regularly up to 10 years. The number of patients at risk for a prescribed score versus time was calculated with the life-table method. The late effects after 5 X 2.0 Gy/wk, in the dose range 40 to 70 Gy and after 2 X 4.0 Gy/wk, in the dose range 40 to 56 Gy have been established. The skin dose is 90% of the referred dose. Dose-response curves, relating the proportion of patients with a certain score at a fixed time and radiation dose and dose-latency curves, relating the latent period for a fixed proportion of patients with a certain score and radiation dose, were constructed. The analysis shows that: ED10/5 yr and ED50/5 yr for 5 X 2.0 Gy/wk is 50 Gy and 65 Gy, respectively, for distinct telangiectasia; The latent period, concerning both a certain frequency and degree of reaction, varies exponentially with dose level; The latent period for 50% of the patients, to obtain a certain score, LP50, is correlated to that for 10%, LP10, with LP50/LP10 = 2.2 +/- 0.2 (S.D.). This correlation is independent of score, total dose, and fractionation; Isoeffective doses for 5 X 2.0 Gy/wk and 2 X 4.0 Gy/wk, determined from the dose-response curves, resulted in the repair exp N between 0.31 and 0.32 and alpha/beta ratio between 2.9 and 3.1 Gy and determined from the dose-latency curves in exp N between 0.30 and 0.32 and alpha/beta ratio between 3.4 and 2.9 Gy. In conclusion, frequent and careful follow-up with registration of normal tissue reactions, until at least 10% of the patients have obtained the prescribed effect, is predictive for the further progression of the late effects. The fractionation characteristics for telangiectasia agree well with those for animal experimental morphological and functional endpoints for late effects in different organs and support the relevance of telangiectasia as a model for predicting late effects.

Breast Neoplasms↗
PubMed1990

Individual variation and dose dependency in the progression rate of skin telangiectasia.

The progression rate of late skin telangiectasia after radiotherapy has been studied prospectively in patients for various fractionation schedules and dose levels. The degree of telangiectasia was scored on an arbitrary scale ranging from no detectable to totally confluent telangiectasia. Skin telangiectasia showed a progressive development at least up to 10 years. The rate of progression was strongly dose dependent. This finding has two important implications: the dose-latency relationship is steep, and the steepness of the dose-response relationship increases with the follow-up time. The most striking finding in this study was that the individual variation in progression rate was very large for the same treatment with a documented small variation in dose. For example, the latency for telangiectasia score 2 ranged between 17 and 90 months after 35 fractions of 1.8 Gy. The reasons for the large individual variation in progression rate are unclear and will be investigated further.

Breast Neoplasms↗
PubMed1990

The source-skin distance measuring bridge: a method to avoid radiation teleangiectasia in the skin after interstitial therapy for breast cancer.

Inappropriate positioning of interstitial Iridium 192 implants, used as booster dose in the breast conserving treatment of mammary cancer, may cause disturbing teleangiectasia of the breast skin, when high radiation doses are delivered on the dermal blood vessels. Based on the localization of the vascular plexuses in human breast skin, and on the dose distribution around different types of interstitial implants, a method is described to avoid overlap between the high dose area of the implant and the blood vessels in the skin. The latter are demonstrated to run within the first 5 mm under the epiderm. For source lengths varying from 5 to 8 cm, simple mathematical relations exist between the maximal security margin (MSM) and intersource distance (E) for single plane implants (MSM = 0.4 (E + 1)), double plane square implants (MSM = 0.4 E) and double plane triangular implants (MSM = 0.4 (E - 1)). We developed a device to measure precisely the distance between the radioactive wires and the overlying skin, along the whole source trajectory. Using this method, the occurrence of teleangiectasia in the breast skin after interstitial implants with Ir 192 may be significantly reduced.

Brachytherapy↗
PubMed1995

Intracranial vascular malformations.

Intracranial vascular malformations are nonneoplastic developmental anomalies that present a variety of clinical patterns, ranging from asymptomatic to fatal intracranial hemorrhage. A practicing radiologist can expect to encounter these abnormalities, which include capillary telangiectasias, venous angiomas (also called developmental venous anomalies), cavernous angiomas, and arteriovenous malformations. The imaging findings that characterize these lesions are reviewed in this article, along with their pathological and clinical features.

Brain↗