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At least 19 recordsLinked to original sources
PubMed1992

Iontophoresis of lidocaine for anesthesia during pulsed dye laser treatment of port-wine stains.

Port-wine stains may be effectively ablated using the pulsed dye laser emitting at a wavelength of 577 or 585 nm. However, the discomfort of this therapy may be severe enough to require reduction of treatment duration thereby increasing the need for repeat sessions. Currently available methods of anesthesia or sedation for pulsed dye laser therapy have drawbacks to their use. We performed a prospective double-blind, placebo-controlled evaluation of the iontophoresis of lidocaine HCl 4% and lidocaine HCl 4% with epinephrine 1:50,000 for local anesthesia during pulsed dye laser ablation of port-wine stains. Eleven patients with port-wine stains completed the initial phase of the study. Pain scale evaluation by patients demonstrated significant decreases in the discomfort of pulsed dye laser impulses by the iontophoresis of lidocaine HCl 4% and lidocaine HCl 4% with epinephrine 1:50,000 (P less than .0001), with no significant difference between these treatments. Follow-up evaluation suggests that iontophoresis has no detrimental effect on pulsed dye laser ablation of port-wine stains, despite significant decreases in perfusion, as measured by laser Doppler velocimetry, of port-wine stain areas receiving iontophoresis of lidocaine with epinephrine. Iontophoresis of lidocaine HCl 4% with or without epinephrine is a safe and effective method of local anesthesia for pulsed dye laser therapy.

Adolescent↗
PubMed1992

Treatment of periorbital port-wine stains with the flashlamp-pumped pulsed dye laser.

Sixty-seven patients with periorbital port-wine stains were treated with the flashlamp-pumped pulsed dye laser at a wavelength of 577 or 585 nm and a pulse-width of 450 microseconds. A retrospective analysis of the efficacy of this treatment was performed by qualitative and quantitative comparison of simultaneously projected pretreatment and post-treatment photographs and by comparison of photographs with a visual analog scale. These periorbital port-wine stains were treated with good-to-excellent results in 95% of the patients. As a result of treatment, macular (ie, nonhypertrophic) lesions, were lightened by an average of 80%. Neither scarring nor permanent pigmentary alteration was noted. Children of all ages were treated without adverse consequences, and the results were comparable to those of adults. The flashlamp-pumped pulsed dye laser treatment of periorbital port-wine stains is effective and safe in patients of all ages and should be considered the treatment of choice for flat and mildly hypertrophic lesions.

Adolescent↗
PubMed1992

Treatment of a port-wine stain in a black patient with the pulsed dye laser.

A black man presenting with a port-wine stain was spot-treated with a flashlamp-pumped pulsed dye laser. The 1 cm2 area was treated with the flashlamp-pumped pulsed dye laser using rhodamine in methanol as the dye, a wavelength of 585 nm, a pulse duration of 450 microseconds, and a circular spot size of 5 mm. Energy density was 7.75 J/cm2. Superficial sloughing of the skin was noted immediately posttreatment. Persistent hyperpigmentation, textural changes to the skin, and no improvement in the port-wine stain were noted at follow-ups 2-, 4-, and 8-months posttreatment.

Arteriovenous Malformations↗
PubMed1992

Argon laser treatment of port-wine stains: the patients' evaluations of the result.

The argon laser is now a well-established method of treating port-wine stains (PWS) in the face and neck areas. Satisfactory results are reported in 44 to 75 percent of cases, but criteria for that classification and the patients' perceptions of the result are seldom given. In the present paper, a sample of 58 patients was used to assess the patients' own perceptions of the degree of lightening and scarring. Three felt the results were excellent, 23 good, 18 fair, and 14 poor. The treatment was considered as unpleasant by 76 percent, and 55 percent of the patients asked for a new consultation. Scarring was noticed by 50 percent. The patients' perceptions of the results and physicians' rating were the same in 69 percent. The best results were obtained in older patients with small port-wine stains. Such lesions also can be treated surgically with good results.

Adolescent↗
PubMed1977

Laser treatment of extensive mixed cavernous and port-wine stains.

An extensive, disfiguring mixed nodular cavernous and port-wine stain of the face of an adult who had psoriasis and diabetes was treated with ruby and argon lasers for a period of seven years with substantial cosmetic improvement. There was no deep scarring, secondary granuloma telangiectatic reactions, or chronic radiation changes. Prolonged treatments were necessary because of the small size of the laser emission impact areas.

Eyelid Neoplasms↗
PubMed1992

Familial multiple lateral telangiectatic nevi (port-wine stains or nevi flammei).

Two families with multiple lateral telangiectatic nevi (LTN) (port-wine stains or nevi flammei) in various areas of the body in two and three generations are presented. In the second family, some members in addition to LTN also had superficial (strawberry) hemangiomas and hemangioma-like venous malformations. The pedigrees of these families indicate autosomal dominant inheritance of multiple LTN.

Adult↗
PubMed1992

Comparative histochemistry of port-wine stains after copper vapor laser (578 nm) and argon laser treatment.

The present study compared the histologic changes occurring 15 min after copper vapor laser (CVL; operating at 578 nm) and argon laser (488/514 nm) treatment of port-wine stains (PWS) over a range of energy densities (8-32 J/cm2) with corresponding pulse widths of 50-200 ms. Frozen tissue sections were stained with nitroblue tetrazolium chloride (NBTC). This histochemical method permits an accurate color differentiation between blue-stained viable and unstained thermally damaged cells. At 8, 10, and 12 J/cm2 the argon-laser injury was confined to epidermal cell layers; none to superficial dermal effects were found. Fluences of at least 15 J/cm2 produced a diffuse NBTC-negative coagulation necrosis. Exposure of PWS skin to 8-12 J/cm2 at 578 nm did not alter the integrity of epidermal cells. In the dermis, damage was confined to blood vessels and surrounding collagen, showing a clear demarcation from adjacent viable structures. The maximum penetration depth achieved with these vessel selective energy densities was 0.44 mm. At 15 J/cm2, besides vascular injury, damage to the basal cell layer also occurred. At fluences of 17-20 J/cm2 a diffuse necrosis similar to that induced by the argon laser was found. Vessel selectivity of the 578 nm wave band was achieved with pulse widths from 50-74 ms, exceeding the estimated "ideal" exposure time (0.1-10.0 ms) for a vascular selective laser effect. The NBTC method allowed identification of subtle laser-induced tissue changes providing accurate quantitative data relating to the extent of vascular injury.

Adult↗
PubMed1979

Dermatological study of 47,XYY males.

Dermatological features of five 47,XYY males are presented. Port-wine stains were observed in 2 cases. As the incidence of port-wine stains among the general population is believed to be 0.5%, this result would seem to indicate that the association of 47,XYY males with port-wine stains is more than a coincidence, though the survey of previous studied failed to reveal any 47,XYY cases with port-wine stains.

Acne Vulgaris↗
PubMed1976

Meningioma following irradiation.

The case of a young woman who developed initial symptoms of an intracranial mass lesion 17 years after undergoing irradiation for a port-wine stain of the right fronto-temporal and periorbital scalp and face is reported. A right sphenoid wing meningioma was removed 6 years later. The possible relationship betweenthe development of the meningioma and the previous radiotherapy is discussed.

Adult↗
PubMed1992

Magnetic resonance imaging of facial vascular anomalies.

In 36 patients, facial vascular anomalies were studied with 46 magnetic resonance (MR) examinations, 9 angiograms, and 5 computed tomographic scans. All lesions were categorized into classic pathologic groups on the basis of radiologic and pathologic studies, clinical examination, and behavior. Overall, 2 juvenile hemangiomas, 3 capillary malformations (port-wine stains), 18 venous malformations, 9 lymphatic malformations, and 4 arteriovenous malformations were found. MR imaging was superior to computed tomography and angiography for demonstrating the precise anatomic extent of the facial vascular anomalies and their relationship to the adjacent soft tissues but was inferior to computed tomography for demonstrating radiopaque structures such as trophic bone changes and phleboliths. MR imaging was also inferior to angiography in determining the nidus and the exact nature of collateral vascular structures in arteriovenous malformations. MR studies confirmed the clinically suspected diagnosis of facial vascular anomalies and demonstrated typical characteristics for each type of lesion. MR imaging is an ideal initial technique to triage patients with facial vascular anomalies for appropriate management, including observation, endovascular therapy, or surgical excision.

Adolescent↗
PubMed1976

Excision of massive hemangioneurofibroma of the face.

Nevus flammeus (cutaneous hemangioma, port-wine stain) may develop proliferative hamartomatous changes and go on to form monstrous deforming tumors. Excision is feasible, and it may be best to do it early. The mentally retarded, institutionalized patient can also benefit from the reconstruction. In 3 cases it was possible to preserve function of the muscles of facial expression, because of the superficial location of the tumor. Techniques to decrease blood loss are of variable value during the operative procedure.

Adult↗
PubMed1975

Chromosome 3 duplication q21 leads to qter deletion p25 leads to pter syndrome in children of carriers of a pericentric inversion inv(3) (p25q21).

Close phenotypic similarity between two cases carrying a rec(3) dup q,inv(3) (p25q21), 12 additional infants from the same inv (3)(p25q21) kindred who lived less than 1 year, and eight cases studied in other medical centers has led us to postulate the existence of a distinct chromosome 3 duplication-deletion syndrome. In the presence of trisomy for (3)q21 leads to qter and monosomy for (3)p25 leads to pter, the facial dysmorphy is unique: a distorted head shape due to irregular cranial sutures, thick low eyebrows, long eyelashes, persistent lanugo, distended veins on the scalp, hypertelorism, oblique palpebral fissures, a very short nose with a broad depressed bridge and anteverted nares, protruding maxilla, thin upper lip, micrognathia, low-set ears, and a short webbed neck. Port-wine stains, congenital glaucoma, cloudy corneas, cleft palate and harelip also occur frequently. Each infant has difficulty sucking and swallowing. Congenital anomalies of the cardiovascular system, of midgut rotation, and of the urogenital system are noted for the infants who died neonatally. Most frequent is a ventricular septal defect, followed by atrial septal defect, patent ductus arteriosus, patent foramen ovale, and coarctation of the aorta. Omphalocele, umbilical hernia, hyperplastic kidneys, polycystic kidneys, double ureter, hydro-ureter, hydronephrosis, and undescended testes often occur. The extremities are short in proportion to the length of the trunk. Clinodactyly, coxa valga, talipes, and spina bifida are frequently observed.

Abnormalities, Multiple↗
PubMed1976

Argon laser management of cutaneous vascular deformities. A preliminary report.

Twenty-two patients with cutaneous vascular malformations were treated with an argon laser. Promising results were obtained in patients with port-wine stains, hemangiomas, telangiectasia and varicose veins. The argon laser shows promise as an effective clinical tool in the treatment of all such cutaneous vascular abnormalities. However, further study of clinical as well as laboratory data is necessary over a long period of time before this modality can be definitely recommended as the treatment of choice for vascular deformities of the skin.

Adult↗
PubMed1992

Flashlamp-pumped pulsed dye laser treatment for pyogenic granuloma.

Pyogenic granuloma is a frequently diagnosed, benign vascular lesion common in children and young adults. Treatment of pyogenic granuloma consists of removal of the lesion for therapeutic as well as diagnostic purposes. Current treatment modalities include curettage with electrodesiccation, cryosurgery, chemical cauterization, and argon laser therapy. However, these methods are not without the risk of complications such as scarring and pigmentary changes. The recently reported success of the flashlamp-pumped pulsed dye laser for treating telangiectasias, hemangiomas, and port-wine stains led us to hypothesize that this same device, using different variables, such as multiple overlapping pulses, would be of benefit in the treatment of pyogenic granuloma. We describe three patients with pyogenic granuloma treated with the pulsed dye laser, with the total number of treatments and energy densities varying according to the size of the initial lesion. All three patients demonstrated complete resolution of lesions with no evidence of scarring, atrophy, or pigment changes. This preliminary report suggests that pulsed laser therapy should be considered in the treatment of pyogenic granuloma, especially in cosmetically sensitive areas.

Adolescent↗
PubMed1992

Limb anomalies associated with chorionic villus sampling.

Data on outcome of pregnancy were obtained in 436 (94%) of 463 patients undergoing chorionic villus sampling (CVS) at Humana Hospital-Michael Reese between January 1, 1989 and November 30, 1990. There were 18 elective abortions, 27 fetal and neonatal losses, and 391 surviving infants. Of the 394 fetuses and infants who were adequately evaluated, a total of 13 (3.3%) had major congenital anomalies, including four with transverse limb reduction deformities, three with cleft lip with or without cleft palate, and one each with a nasal encephalocele, large port-wine stain, craniosynostosis, omphalocele with associated defects, ambiguous genitalia, and undescended testes. The limb malformations in the four affected infants were all very similar and were comparable to those described by others in association with CVS. Three of the cases of limb malformations followed transcervical CVS; one followed a transabdominal procedure. The procedures were performed at 9.5, 9.5, 10.5, and 11 weeks' gestation. An adequate sample was obtained with a single attempt in each case. These observations, in conjunction with others in the literature, suggest that there is an increased risk of limb anomalies associated with CVS. A vascular etiology, related to either decreased fetal perfusion or thrombosis of the sampling site with subsequent embolization, is suggested.

Chorionic Villi Sampling↗
PubMed1992

[Hemangiomas and superficial vascular malformations: classification].

Superficial vascular malformations of the face, trunk and limbs are better known today, and they can be divided up into simple and complex vascular malformations. Simple vascular malformations may form five major categories: immature hemangiomas of infants, port-wine stains, capillarovenous angiodysplasias, and arteriovenous fistulae and malformations. Complex angiodysplasias are systematized (Sturge-Weber and Bonnet-Dechaume-Blanc syndromes, Cobb's metameric angiomatosis, Klippel-Trenaunay and Parkes Weber's syndromes) or disseminated (Weber-Osler-Rendu disease and blue rubber-bleb nevus syndrome). Various modalities of treatment may be contemplated, according to the type of malformations, and an interdisciplinary consultation is essential to decide whether a watch-and-wait policy, a physical method (laser), embolization, fibrosing injections, vascular, maxillofacial or plastic surgery, or a successive combination of various techniques should be resorted to.

Angiodysplasia↗