A narrative review of the quality of life scales specific for chronic venous diseases.

ABSTRACT: To review the various quality of life (QoL) scales specific for chronic venous diseases (CVDs) and provide guidance and a reference for researchers to select the ideal measurement scale before studying QoL in patients with CVDs.The EBSCO, Ovid, PubMed, Wanfang, and CNKI databases were searched for the keywords "vein," "quality of life," and "scale/questionnaire," and various scales used to measure QoL in patients with CVDs. The QoL aspects were investigated and researched, and then, the search results were screened and summarized.A total of 10 major scales related to the QoL in patients with CVDs were included. The scales differed in dimension, reliability, validity, scoring method, evaluation method, and scope of application.The investigator should select the chronic venous disease QoL scale according to the research purpose and subjects, and then implement the scale to compare the specific aspects of QoL in patients with different CVDs.

Successful Treatment of Generalized Essential Telangiectasia With 6-Mercaptopurine.

Generalized essential telangiectasia (GET) is a notoriously difficult to treat disorder with no current satisfactory treatments. This case and discussion report the use of 6-mercaptopurine (6-MP) as a successful treatment for GET. Moreover, we show that GET may represent a state of increased angiogenesis, a paradigm shift from the current understanding that these telangiectasias represent dilatations of only pre-existing vessels. This new view of GET may drive others to look at novel agents for treatment.

J Drugs Dermatol. 2017;16(3):280-282.

Megalencephaly-capillary malformation polymicrogyria: A review and complex pediatric case report.

Megalencephaly-Capillary Malformation Polymicrogyria (M-CAP) is a rare genetic disorder characterized by a spectrum of anomalies including macrocephaly and neurovascular malformations. Although developmental delays have been identified, research is devoid of neuropsychological data. This case report presents the neuropsychological profile of a 7-year-old, identified with M-CAP. Neuropsychological evaluation was completed subsequent to medical diagnosis. Reports from both parents and teachers included cognitive regression; specifically in the recall of learned material, reading, and information sequencing. Direct testing revealed a WISC-IV GAI at <1st percentile, a diverse range of scores across the battery, and a splinter skill strength of average to above on visual memory tests. Performance included below grade level reading and writing, reduced adaptive functioning, and reported executive dysfunction. Her strong visual memory skills were recommended as a medium to enhance learning. Neurocognitive deficits revealed diverse, multisystem and multifocal impairments. The neuropsychological evaluation also showed significant decline from the previous evaluation and prompted a neurologic consult and corrective surgical procedure.

[Transitory (evening) venous reflux in patients with intracutaneous varicosity and medicamentous correction thereof].

The authors carried out a study aimed at revealing transitory refluxes along the great saphenous vein (GSV) in patients with intracutaneous varicosity, and at investigating the possibility of removing them by means of preparations of micronized purified flavonoid fraction (MPFF). The study included a total of one hundred and forty-seven 21-to-47-year-old (mean age 31±4.4 years) women presenting with cutaneous varicosity (class C1s). The duration of skin manifestations amounted to 9.4±3.9 years (varying from 4 to 24 years). Telangiectasias were present in 69 (46.9%) women, 36 (24.5%) women had reticular varicosity, and 42 (28.6%) a combination thereof. An author-devised test was used with prolonged orthostatic load consisting in carrying ultrasound duplex scanning twice: in the evening after 6 p. m. and in the morning before 10 a.m., assessing the evening and morning parameters of the GSV, as well as the increment of the diameter of the vein at evening measurement as compared with the morning indices. Women with transitory refluxes along the GSV (n=59) underwent treatment with MPFF preparations (Detralex, Servier) during 60 days at a daily dose of 1,000 mg. The morning examination showed that there was no reflux along the GSV. The evening examination revealed refluxes along the GSV of various pattern and extent in 59 (40.1 %). All the 59 patients with evening refluxes presented complaints for increased fatigability, heaviness in the lower limbs by the end of the day. After 2 months of treatment, of the 59 women with initial reflux, 38 (64.4%) patients had no reflux and in 21 (35.6%) the extent of reflux decreased more than twofold. The evening diameter of the GSV decreased from 5.7 mm (95% CI 4.0-7.1) to 5.2 mm (95% CI 5.5-6.5) and the orthostatic gradient decreased from 0.9 mm (95% CD 0.6-1.3) to 0.6 mm (95% CI 0.4-0.8), p=0.000001. The initial complaints for heaviness in the legs after treatment disappeared in 76.6% of patients (50 of 59 subjects); in 9 women intensity of complaints decreased. The quality of life index decreased from 42 (95% CI 28-55) to 31 (95% CI 15-52) points (p=00001). Conclusions were drawn that in intracutaneous reflux in 40.1% of cases there appear transitory evening refluxes along the GSV revealed in the day-time orthostatic test. Taking MPFFs at a dose of 1,000 mg daily during 2 months removes evening transitory reflexes in 64.4% of cases and in 35.6% of cases decrease them, thus promoting contributing to decreased intensity of venous complaints and an increase in quality of life.

A pilot study of body image dissatisfaction and the psychological impact of systemic sclerosis-related telangiectases.

OBJECTIVES: To determine the extent of body image dissatisfaction (BID) in patients with self-reported systemic sclerosis (SSc)-related telangiectases and to identify the demographic, psychological and disease-related correlates of BID within a cross-sectional study. METHODS: Patients with SSc were invited to participate in a questionnaire survey. Each completed the Adjusted Satisfaction with Appearance Scale (ASWAP), the Hospital Anxiety and Depression Scale (HADS) and an open-ended telangiectases questionnaire. Thematic analysis was utilised to describe the qualitative data. RESULTS: 141 patients with SSc participated (83% female, 70% limited cutaneous SSc, median age 62 years). Telangiectases were reported by 113 (80%). ASWAP 'dissatisfaction with appearance' scores were significantly higher in those reporting telangiectases (p=0.02). Anxiety and depression scores were similar in those with and without telangiectases. Those reporting telangiectases were more likely to be anticentromere positive (40% vs. 18%, p=0.02) and to have a history of severe digital ischaemia (38% vs. 18%, p=0.04) than those not. Qualitative analysis revealed four themes: changes in behaviour as a result of telangiectases, public and private self-image, negative emotional impact of telangiectases and appreciation of life. CONCLUSIONS: BID, as measured by the ASWAP 'dissatisfaction with appearance' subscale, was significantly higher in patients with telangiectases. Telangiectases were associated with anticentromere positivity and digital ischaemia, lending further support for telangiectases as a potential marker for vascular involvement. Qualitative analysis provided new insights into the thoughts and feelings of patients with telangiectases. Our findings highlight the impact of telangiectases and the need to address and manage related concerns.

Depression is associated with some patient-perceived cosmetic changes, but not with radiotherapy-induced late toxicity, in long-term breast cancer survivors.

OBJECTIVE: Although depression is prevalent in long-term breast cancer survivors (LTBCS; ≥ 5 years since diagnosis), it is underdiagnosed and undertreated. A better understanding of factors associated with depression could improve depression screening, treatment, and prevention in this population. Our study aimed to assess the link between patient and doctor ratings of breast cosmetic outcomes, late radiotherapy toxicity, and depression in LTBCS. METHODS: In all, 214 patients recruited from the ARCOSEIN study were assessed for late radiotherapy toxicity (by using the LENT-SOMA scale) and patient and doctor ratings of breast cosmetic outcomes (mean = 6.7 years since the end of treatment). We reassessed 120 of these patients for depression (HAD) during a second wave of long-term assessment (mean = 8.1 years since the end of treatment). We used univariate analyses and polytomous logistic regression analyses to predict the HAD depression, which was defined as follows: normal, 0-7 points; and significant depression, ≥ 8 points (8-10 points, possible depression; ≥ 11 points, probable depression). RESULTS: The mean HAD depression score was 4.5 ± 3.6. 19. 2% of our population had significant depression, 6.7% with probable depression, and 12.5% with possible depression. Significant depression was not associated with late radiotherapy toxicity or initial cancer-related variables. Patients with probable depression reported worse cosmetic outcomes than nondepressed patients in terms of perceived breast largeness (p = 0.04), breast deformation (p = 0.02), and changes in skin pigmentation (p = 0.03). CONCLUSIONS: In LTBCS, depression seems to be more strongly associated with changes in some patients' perceived breast cosmetic outcome than late treatment toxicity or initial cancer-related variables.

[Phlebosclerosing treatment of telangiectasias of lower extremities]. / Fleboskleroziruiushchee lechenie teleangiéktazii nizhnikh konechnostei.

Our experiences include 124 patients (women) aged 25-50 years. Microsclerotherapy was used with 0.5% solution of etoxisclerole and 0.2% solution of fibrovein. The compressive microsclerotherapy proved to be an effective and harmless method of treatment of telangiectasias giving good cosmetic results and arresting clinical symptoms thus improving quality of life.

A prospective study of the impact of laser treatment on vascular lesions.

BACKGROUND: Vascular lesions, especially on exposed sites, can be unsightly and may cause significant psychological distress. Lasers are effective in treating such lesions, but relatively few studies have been performed looking at psychological scoring before and after laser therapy. OBJECTIVES: To assess the change in psychological distress in patients with vascular lesions following laser treatment. PATIENTS AND METHODS: A prospective study was performed with patients recruited over a 3-month period. Psychological distress was measured using subjective scores on a standard questionnaire before treatment and at a 6-month follow-up. Each patient was treated every 4-8 weeks with an appropriate laser by the same dermatologist until discharge. Forty-two patients were recruited with one of four diagnoses: telangiectasia, port wine stain (PWS), vascular spider or cherry angioma, which occurred mainly on facial or exposed sites. RESULTS: Following laser treatment, there was a significant decrease in subjective scores of patients with telangiectasia and vascular spiders. Patients with PWS showed objective improvement but this was not reflected in their subjective scores. Psychological distress had reduced significantly in patients with less severe vascular lesions. CONCLUSIONS: Laser treatment of minor vascular lesions leads to objective improvement, which is paralleled by psychological benefit, but objective benefit in PWS may not be perceived as beneficial by patients.

Patient's evaluation of argon laser therapy of port wine stain, decorative tattoo, and essential telangiectasia.

One hundred fourteen patients were studied to assess their perception of the results of argon laser therapy for port wine stains (PWS), tattoos, or essential telangiectasia of legs. At least 1 yr following treatment patients were surveyed using a 30-item mail questionnaire. A 91% response rate was achieved. The findings indicate that patients with PWS and tattoo treated with argon laser are moderately satisfied with the results and 85% of them would have treatment again. Laser therapy of these lesions should be continued. Treatment results of essential telangiectasia of the legs are disappointing and only 49% of patients would have treatment again. Discontinuance of argon laser therapy using the described techniques is recommended.

[Strategies used by patients with lateral telangiectatic naevi to handle their problems]. / "Bewältigungsstrategien" bei Patienten mit lateralen teleangiektatischen Naevi.

Considering the suitableness of operative therapies for remarkable skin defects without progrediency or malignity, we studied patients' feelings, cognitions and ways of acting with a special questionnaire. The forms were filled in by 28 patients with lateral telangiectatic naevi and a control group of 60 persons with normally constituted skin. The results did not show significant differences between the two groups. Therefore, the indications for surgery or radiotherapy have to be set up very cautiously.