ABSTRACT
PURPOSE: The Curaçao criteria are well-established diagnostic criteria for hereditary hemorrhagic telangiectasia (HHT), but they lack details regarding a predictive presentation of epistaxis and telangiectasias. This study collects and compares data in HHT and population cohorts to inform the application of these criteria. METHODS: In-person interviews regarding epistaxis and targeted examination for telangiectases in a general population cohort (n = 204) and an HHT cohort (n = 432) were conducted. RESULTS: Frequency of epistaxis, rather than intensity or duration, was the best discriminator of HHT. A cutoff of ≥4 nosebleeds per year alone yielded a diagnostic sensitivity of 97%, and specificity of 84%. The mean number of telangiectases at the sites investigated was 0.4 in the general population cohort and 26.5 in the HHT cohort. The most distinctive sites for telangiectases in HHT were lips and palmar fingers, whereas telangiectases of the face and dorsum of the hand were comparable in both cohorts. CONCLUSION: We propose that the Curaçao criteria be modified to include the following cutoffs: (1) epistaxis frequency of ≥4 nosebleeds per year and (2) telangiectasia count of at least 2 in characteristic locations (palmar aspect of fingers, lips, and oral cavity), and that cutaneous telangiectases at other sites not be considered relevant for diagnostic purposes.
Subject(s)
Telangiectasia, Hereditary Hemorrhagic , Telangiectasis , Humans , Telangiectasia, Hereditary Hemorrhagic/complications , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Telangiectasia, Hereditary Hemorrhagic/epidemiology , Epistaxis/epidemiology , Epistaxis/etiology , Epistaxis/diagnosis , Curacao , Telangiectasis/diagnosis , Telangiectasis/epidemiology , PatientsABSTRACT
We aim to report a particular case of cutaneous telangiectasias on the arms after immunotherapy with trastuzumab plus paclitaxel to treat breast cancer. New oncology therapies reflect a major advance in cancer treatment. They greatly increase survival; however, they still cause certain adverse cutaneous events that should be taken into account for their proper management.
Subject(s)
Humans , Female , Adult , Telangiectasis/epidemiology , Breast Neoplasms/complications , Trastuzumab/adverse effectsABSTRACT
PURPOSE: Weekly irradiation in breast cancer in elderly patients is a treatment option, whose tolerance may be influenced by the fractionation used. The objective of this study is to compare the tolerance and long-term side effects of two different fractionations. MATERIALS AND METHODS: 47 elderly patients were recruited after conservative or radical treatment that also received irradiation with a dose per fraction of 6.25 Gy or 5 Gy for one session per week, 6 sessions in total. The long-term tolerance results are compared by assessing toxicity using CTCAE version 5.0 scales for dermatitis, telangectasia, fibrosis and pain of the irradiated breast. In addition, objective parameters of skin status (erythema, hyperpigmentation, elasticity and hydration) by a multi-probe MultiSkin Test-Center system were obtained and compared between groups. RESULTS: After an average follow-up of 5 years, all patients were free of disease and with complete local control. A total of 20 patients with 6.25 Gy fractionation and 27 patients with 5 Gy fractionation have been included. Patients treated with lower fractionation had a lower incidence of dermatitis, telangectasia, fibrosis, or local pain. The decrease in elasticity measured by the multi-probe system was smaller with the fractionation of 5 Gy. No differences were observed in the other objective parameters. CONCLUSION: Weekly irradiation with 5 Gy fractionation is better tolerated than with higher fractionation.
Subject(s)
Breast Neoplasms/radiotherapy , Radiation Dose Hypofractionation , Aged , Aged, 80 and over , Breast Neoplasms/surgery , Dermatitis/epidemiology , Dermatitis/etiology , Female , Fibrosis/epidemiology , Fibrosis/etiology , Humans , Margins of Excision , Pain/epidemiology , Pain/etiology , Radiation Injuries/epidemiology , Radiation Tolerance , Radiotherapy Dosage , Telangiectasis/epidemiology , Telangiectasis/etiology , Time FactorsABSTRACT
El objetivo del trabajo consiste en resaltar la frecuencia de presentación y caracterización de los pseudotumores mesenquimáticos en la cavidad bucal.Se analizó la presentación de pseudotumores de origen mesenquimáticos dentro de la cavidad bucal, observando la histopatología y teniendo en cuenta las variables sexo, edad y localización. Se realizó una investigación retrospectiva de los archivos del laboratorio de Anatomía Patológica Dr. Walter A. Alsina de la FOUNNE, revisando los protocolos de biopsias y preparados histopatológicos informados durante el año 2005. Del total de 189 casos, se separaron 59 correspondientes a los Pseudotumores de origen mesenquimáticos (37 por ciento). Dentro de este grupo y teniendo en cuenta el orden de frecuencia se observó: Hiperplasia Fibrosa 68 por ciento; Granuloma Telangiectásico 20 por ciento y Granuloma Gigantocelular Periférico 12 por ciento. La edad media de presentación de los pseudotumores mesenquimáticos bucales en la muestra estudiada fue de 46 años y la localización más frecuente, encía. La diferencia entre sexos no es significativa.(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Mouth Neoplasms/classification , Mouth Neoplasms/epidemiology , Hyperplasia/epidemiology , Telangiectasis/epidemiology , Data Interpretation, Statistical , Retrospective Studies , Age Distribution , Sex Distribution , Argentina/epidemiologyABSTRACT
El objetivo del trabajo consiste en resaltar la frecuencia de presentación y caracterización de los pseudotumores mesenquimáticos en la cavidad bucal.Se analizó la presentación de pseudotumores de origen mesenquimáticos dentro de la cavidad bucal, observando la histopatología y teniendo en cuenta las variables sexo, edad y localización. Se realizó una investigación retrospectiva de los archivos del laboratorio de Anatomía Patológica Dr. Walter A. Alsina de la FOUNNE, revisando los protocolos de biopsias y preparados histopatológicos informados durante el año 2005. Del total de 189 casos, se separaron 59 correspondientes a los Pseudotumores de origen mesenquimáticos (37 por ciento). Dentro de este grupo y teniendo en cuenta el orden de frecuencia se observó: Hiperplasia Fibrosa 68 por ciento; Granuloma Telangiectásico 20 por ciento y Granuloma Gigantocelular Periférico 12 por ciento. La edad media de presentación de los pseudotumores mesenquimáticos bucales en la muestra estudiada fue de 46 años y la localización más frecuente, encía. La diferencia entre sexos no es significativa.