ABSTRACT
BACKGROUND: Infantile haemangiomas (IH) are common benign tumours in infancy. Most IH resolve spontaneously, but some require treatment due to ulceration, functional impairment or cosmetic disfiguration. While systemic propranolol is effective in many cases, laser therapy may be a safe topical alternative. OBJECTIVE: To assess the efficacy of combined Nd:YAG/pulsed dye laser (PDL) or PDL alone for therapy of IH. PATIENTS AND METHODS: A total of 271 IH in 149 infants were treated with combined Nd:YAG/PDL or PDL alone. Based on photographs before and 4-6 weeks after the last treatment, the results were evaluated independently by three physicians. Remissions were categorized as 0-25% (I), 26-50% (II), 51-75% (III) and 76-100% (IV). RESULTS: In total, 472 laser treatments were performed. In 137 of 149 infants (91.9%) laser therapy was performed during a short sevoflurane mask anaesthesia, while 12 of 149 infants (8.1%) received topical anaesthetic gel. Combined Nd:YAG/PDL was applied in 187 of 271 IH (69.0%), while PDL alone in 84 of 271 IH (31.0%). On average, 1.74 treatments per IH were necessary (Nd:YAG/PDL: 1.95, PDL: 1.26). Moderate or strong (III/IV) improvement was observed in 92.4% of all IH treated. No serious adverse effects were observed. CONCLUSION: Combined Nd:YAG/PDL therapy is an effective and well-tolerated local treatment option for IH of any classification, in any phase of development and at any age. With regard to the systemic use of propranolol, combined Nd:YAG/PDL therapy seems a safe and promising alternative in many cases.
Subject(s)
Hemangioma/surgery , Lasers, Dye/therapeutic use , Lasers, Solid-State/therapeutic use , Skin Neoplasms/surgery , Adrenergic beta-Antagonists/therapeutic use , Child , Combined Modality Therapy , Female , Hemangioma/drug therapy , Humans , Infant , Lasers, Dye/adverse effects , Lasers, Solid-State/adverse effects , Male , Propranolol/therapeutic use , Retrospective Studies , Skin Neoplasms/drug therapy , Treatment OutcomeSubject(s)
Ear Neoplasms/genetics , Ear Neoplasms/therapy , Ear, External , Genotype , Nasopharyngeal Neoplasms/genetics , Nasopharyngeal Neoplasms/therapy , Phenotype , Rhabdoid Tumor/genetics , Rhabdoid Tumor/therapy , SMARCB1 Protein/genetics , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemoradiotherapy , Ear Neoplasms/pathology , Gene Expression Regulation, Neoplastic/genetics , Humans , Maintenance Chemotherapy/methods , Male , Nasopharyngeal Neoplasms/pathology , Neoplasm Staging , Rhabdoid Tumor/pathology , Treatment OutcomeABSTRACT
We report on a case of Pseudomonas aeruginosa sepsis and consecutive lung abscess in a 13-year-old patient with acute B-cell leukemia. At first, radiographic findings strongly suggested presence of pulmonary aspergilloma and only microbiological testing of the surgically enucleated mass revealed the correct underlying pathogen and confirmed final diagnosis.
Subject(s)
Leukemia, B-Cell/diagnosis , Lung Abscess/diagnosis , Mycetoma/diagnosis , Opportunistic Infections/diagnosis , Pseudomonas Infections/diagnosis , Pseudomonas aeruginosa , Pulmonary Aspergillosis/diagnosis , Adolescent , Diagnosis, Differential , Humans , Lung/pathology , Lung/surgery , Lung Abscess/pathology , Lung Abscess/surgery , Male , Opportunistic Infections/pathology , Opportunistic Infections/surgery , Tomography, X-Ray ComputedABSTRACT
We report the clinical and pathological findings of an unusual invasive fungal infection in a 13-year-old girl with T-NHL. The diagnosis of disseminated Zygomycosis was made four days after onset of clinical symptoms. Risk factors for Zygomycosis were prolonged neutropenia, corticosteroids, and steroid induced diabetes mellitus.
