ABSTRACT
Resumo A escleroterapia é, atualmente, o tratamento de escolha para telangiectasias e veias reticulares, apresentando nível de recomendação 1ª pela diretriz europeia para escleroterapia. Os efeitos colaterais mais comuns desse procedimento são a hiperpigmentação e o matting telangiectásico, sendo este último um dos mais temidos em virtude do dano estético e da dificuldade de tratamento. O matting se refere a vasos com diâmetro inferior a 0,2 mm que podem surgir esporadicamente ou em áreas bem definidas, principalmente nos membros inferiores. Este relato apresenta um caso de matting tratado com o uso de tartarato de brimonidina tópico.
Abstract Sclerotherapy is currently the treatment of choice for telangiectasias and reticular veins, with grade 1A recommendation in the European Guideline for sclerotherapy. The most common side effects of this procedure are hyperpigmentation and telangiectatic matting, the second of which provokes great concern because of the esthetic damage and the difficulty of treatment. Matting refers to vessels with a diameter of less than 0.2 mm, which may emerge irregularly or in well-defined areas, especially on the lower limbs. This report presents a case of matting treated with topical Brimonidine Tartrate.
Subject(s)
Humans , Female , Adult , Young Adult , Telangiectasis/drug therapy , Sclerotherapy/methods , Brimonidine Tartrate/therapeutic use , Veins , Lower ExtremityABSTRACT
La Telangiectasia Macular Eruptiva Perstans (TMEP), forma infrecuente de mastocitosis cutánea consiste en la proliferación anormal de mastocitos en dermis papilar sin participación de otros órganos. Afecta mayormente a adultos, con algunos informes en niños. Típicamente, las lesiones de TMEP son máculas eritematosas con finas telangiectasias, distribuidas principalmente en tronco y extremidades superiores con un patrón simétrico, puede presentar afectación sistémica o asociarse con neoplasias linfoproliferativas. Se presentan dos casos de TMEP en una mujer de 32 años cuyo inicio coincidió con su primera gestación y el de una mujer de 55 años, ambas sin síntomas sistémicos, se discute la presentación clínica, histopatología y tratamiento.
Macular telangiectasia eruptiva perstans (TMEP), an uncommon form of cutaneous mastocytosis, consists in the abnormal proliferation of mast cells in the papillary dermis without the participation of other organs. It affects almost exclusively adults, with some reports in children. Typically, TMEP lesions are erythematous macules with fine telangiectasias, distributed mainly in the trunk and upper limbs with a symmetrical pattern, may present systemic involvement or be associated with lymphoproliferative neoplasms. We present two cases of TMEP in a 32-year-old woman whose onset coincided with her first pregnancy and that of a 55-yearold woman, both without systemic symptoms, whose clinical presentation, histopathology and treatment are discussed.
Subject(s)
Humans , Female , Adult , Middle Aged , Telangiectasis/diagnosis , Telangiectasis/pathology , Mastocytosis/pathology , Mastocytosis, Cutaneous/diagnosis , Telangiectasis/drug therapy , Mastocytosis, Cutaneous/drug therapy , Histamine Antagonists/therapeutic useABSTRACT
Pigmented purpuric dermatoses are chronic and relapsing disorders characterized by a symmetrical rash of petechial and pigmentary macules, mainly confined to the lower limbs. Purpura annularis telangiectodes of Majocchi is a less common variant of Pigmented purpuric dermatoses characterized by punctate telangiectatic macules progressing to annular, hyperpigmented patches with central clearing and infrequent atrophy. A 12 year-old girl presented with asymptomatic round to oval reddish brown macules, present symmetrically over her lower and upper limbs for 3 years. Few lesions were annular in shape. Biopsy from the lesion was compatible with Pigmented purpuric dermatoses. On the basis of clinical and histopathological findings, a diagnosis of Purpura annularis telangiectodes of Majocchi was made. The patient began phototherapy thrice a week and showed excellent response.
Subject(s)
Child , Female , Humans , PUVA Therapy/methods , Pigmentation Disorders/drug therapy , Purpura/drug therapy , Telangiectasis/drug therapy , Biopsy , Leg Dermatoses/drug therapy , Leg Dermatoses/pathology , Pigmentation Disorders/pathology , Purpura/pathology , Radiation Dosage , Treatment Outcome , Telangiectasis/pathologyABSTRACT
The clinical and imaging findings and therapeutic outcomes of intravitreal bevacizumab injection in a patient with macular telangiectasia type 2 are described. The patient first presented with the non-proliferative stage of the disease for 4 months, then the disease transformed to the proliferative stage. In the proliferative period, the patient was treated with intravitreal bevacizumab injections as-clinically warranted. Over a follow up period lasting 26 months, the patient received 6 intravitreal bevacizumab injections, the visual acuity improved from 20/100 to 20/40, the central retinal thickness decreased from 318 microns to 198 microns. This case implies that the patients with non-proliferative macular telangiectasia type 2 should be followed carefully for proliferative transformation, and intravitreal bevacizumab treatment seems to be effective for proliferative macular telangiectasia type 2
Subject(s)
Humans , Female , Telangiectasis/drug therapy , Retinal Diseases/therapy , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized , Intravitreal InjectionsABSTRACT
A 13-year-old boy was referred because of visual deterioration in his right eye. The visual acuity was two meters of counting fingers. Indirect ophthalmoscopy and biomicroscopy revealed exudative macular edema as well as tumor-like telangiectatic vessels and exudation in temporal periphery. With diagnosis of Coats' disease (stage II) confirmed by fluorescein angiography, three intravitreal injections of bevacizumab were performed at 6-week intervals. One year after the last injection, there was a significant resolution of macular edema as well as visual acuity improvement to 20/20. This is the first case report in which a distinct improvement in macular edema was observed with intravitreal bevacizumab in Coats' disease.
Subject(s)
Adolescent , Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Humanized , Diagnosis, Differential , Follow-Up Studies , Humans , Injections , Macular Edema/complications , Macular Edema/diagnosis , Macular Edema/drug therapy , Male , Microscopy, Acoustic , Ophthalmoscopy , Retinal Diseases/complications , Retinal Diseases/diagnosis , Retinal Diseases/drug therapy , Retinal Vessels/pathology , Telangiectasis/complications , Telangiectasis/diagnosis , Telangiectasis/drug therapy , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity , Vitreous BodySubject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized , Combined Modality Therapy , Fluorescein Angiography , Humans , Injections , Male , Middle Aged , Photochemotherapy , Retinal Diseases/diagnosis , Retinal Diseases/drug therapy , Retinal Diseases/physiopathology , Retinal Neovascularization/diagnosis , Retinal Neovascularization/drug therapy , Retinal Neovascularization/physiopathology , Retinal Vessels/pathology , Telangiectasis/diagnosis , Telangiectasis/drug therapy , Tomography, Optical Coherence , Treatment Outcome , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity , Vitreous Body , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Vitreous BodyABSTRACT
Mastocitosis es una enfermedad poco frecuente, caracterizada por incremento en el número de células cebadas en diferentes tejidos y órganos. El sitio más frecuentemente comprometido en cualquier variedad de mastocitosis es la piel. Dentro de las mastocitosis cutáneas se encuentran: uticaria pigmentosa, mastocitoma solitario, mastocitosis cutánea difusa y telangiectasia macularis eruptiva perstans. Telangiectasia macularis eruptiva perstans es una entidad poco frecuente dentro de las mastocitosis cutáneas. Se caracteriza por múltiples placas confluentes color rojizo o café, ubicadas frecuentemente en el tórax, aunque también en cara. Ocurre principalmente en adultos de mediana edad, y la mayoría de los paciente con esta enfermedad sólo presentan compromisos cutáneo. El pronóstico en general es favorable, con episodios de urticaria o síntomas constitucionales. Sin embargo, también se ha descrito asociación con enfermedades sistémicas. Se presenta el caso de una paciente de 67 años con máculas café y telangiectasias en tórax anterior, espalda y brazos, acompañada de hiperpigmentación. Las lesiones desaparecieron después de maniobras de comprensión y el signo de Darier fue negativo. La biopsia demostró la epidermis con leve espongiosis y la dermis con infiltración perivascular e intersticial significativa de mastocitos que se tiñen con Giemsa. No se observaron ni granulomas ni vasculitis. Se confirma el diagnóstico de telangiectasia macularis eruptiva perstans. Se discuten características clínicas, diagnósticas y terapéuticas de rara condición.
Subject(s)
Female , Aged , Humans , Mastocytosis, Cutaneous/pathology , Telangiectasis/pathology , Histamine H2 Antagonists , Hyperpigmentation , Mastocytosis, Cutaneous/diagnosis , Mastocytosis, Cutaneous/drug therapy , Telangiectasis/diagnosis , Telangiectasis/drug therapyABSTRACT
A total of 15 females suffering from Erythematotelangiectatic rosacea and 12 females free from other dermatological lesions was selected. Demodex folliculorum infestation density in both patients and controls was evaluated by noninvasive skin surface biopsies. Five facial sites were selected. The daily topical application of 1/3 diluted camphor oil with glycerol and 500 mg metronidazole orally were given for 15 days. The results were very successful with no clinical side effects
Subject(s)
Humans , Female , Skin Diseases , Telangiectasis/drug therapy , Biopsy , Erythema/drug therapy , Camphor , Plant Oils , Metronidazole , Treatment Outcome , Mite Infestations/drug therapyABSTRACT
La telangiectasia macularis eruptiva perstans (TMEP) es una forma de mastocitosis cutánea poco frecuente, que se manifiesta casi exclusivamente en adultos. Su diagnóstico es básicamente clínico y no se dispone hasta la actualidad de una terapéutica específica eficaz. Se presentan cuatro pacientes de sexo masculino, edad promedio de 54 años, con manifestaciones clínicas e histológicas de TMEP, en diferentes períoddos de evolución. Todos presentaron patología úlcero éptica, asociación frecuente de las mastocitosis cutáneas. Objetivo: Presentación clínica de una forma poco frecuente de mastocitosis cutánea y revisión de la bibliografía
Subject(s)
Humans , Male , Middle Aged , Mastocytosis/diagnosis , Telangiectasis/diagnosis , Mastocytosis/drug therapy , Mastocytosis/therapy , Telangiectasis/drug therapy , Telangiectasis/pathology , Peptic Ulcer/complicationsABSTRACT
Telangiectasia macularis eruptiva perstans é forma rara de mastocitose que ocasionalmente afeta crianças. Múltiplas máculas eritematoacastanhadas e telangiectasias surgem principalmente no tronco. O prurido pode ocorrer sendo brando ou intenso. A maior parte dos pacientes apresenta quadro exclusivamente cutâneo. É descrito caso em criança de cinco anos de idade com aspectos clínicos de telangiectasia macularis eruptiva perstans que melhorou com o uso de cetotifeno