Clinical Outcomes of Small Infantile Hemangiomas Treated With Pulsed Dye Laser.

BACKGROUND: Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of Pediatrics' Clinical Practice Guideline. Conversely, strategies for the management of small, low-risk lesions have not been established; however, pulsed dye laser (PDL) is often used to treat these lesions. OBJECTIVE: To investigate clinical outcomes of PDL in small IH lesions. PATIENTS AND METHODS: Fifty-three cases with 58 small IHs which did not meet the criteria for high-risk lesions in the guideline and were treated only with PDL were retrospectively reviewed. The characteristics of IHs and residual skin changes after treatment were evaluated. RESULTS: Forty-seven lesions (81.0%) were superficial hemangiomas, whereas 11 (19.0%) were combined-type. The median maximum diameter was 10.0 mm. Forty-five lesions (77.6%) exhibited various residual skin changes after PDL treatment, including anetoderma (53.5%), telangiectasia and erythema (43.1%), hyperpigmentation (34.5%), redundant skin (3.4%), and fibrofatty tissue (3.4%). Of these, the incidence of anetoderma and fibrofatty tissue were significantly higher in the combined group than in the superficial group ( p = .036 and .033, respectively). CONCLUSION: Even small lesions, especially combined-type, often result in cosmetic problems after PDL treatment.

Cutaneous manifestations of antiphospholipid syndrome.

Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder in which autoantibodies are produced against a variety of phospholipids and phospholipid-binding proteins. The purpose of this article is to review cutaneous findings in patients with APS diagnosis. An overview regarding prevalence, description, pathogenesis and histopathology, are described for cutaneous manifestations of APS.

Anetoderma in a Patient with Newly Diagnosed Hodgkin's Lymphoma.

A previously healthy 28-year-old woman was admitted to the hospital with respiratory failure and was found to have significant lymphadenopathy on her CT scan. A lymph node biopsy was performed; the pathology was consistent with a diagnosis of Hodgkin's lymphoma and the patient was noted to have multiple, wrinkled, nonscaly, oval-shaped papules that were easily compressible (Figure 1) and were present on the upper and lower extremities, abdomen, chest, and back. The lesions were entirely asymptomatic and had first developed 1 year prior to presentation. Since their initial development, the wrinkled papules had continued to crop up. Some of the lesions began as brownish-red papules and subsequently turned skin-colored.Punch biopsies of the lesional and unaffected skin were performed. A Verhoeff-Van Gieson (VVG) stain showed loss of dermal elastic tissue in the lesional skin, compared to that of the unaffected skin. The clinical and histologic examinations were consistent with the diagnosis of anetoderma.

Primary Anetoderma and Acquired Cutis Laxa associated with Glomerulonephritis in a 37-year-old Filipino male: A case report

@#A 37-year-old Filipino man presented with a 9-month history of sagging skin progressing cephalocaudally from the chin and neck to the axillae, side of the trunk, and pelvic area. This was followed by a 2-month history of increasing serum creatinine levels associated with periorbital and bipedal edema, generalized weakness, decreased appetite, vomiting, and headache. Subsequently, skin-colored, non-tender sac-like plaques appeared on the abdomen, inguinal, and intergluteal areas. Histopathology of the latter lesions showed increased spaces between collagen bundles in the dermis. Staining with Verhoeff-van Gieson revealed focal sparse elastic fibers in the papillary dermis compared to that of the reticular dermis consistent with anetoderma. Further work-up revealed normal ANA titer and low serum C3. Kidney biopsy showed IgG deposition in the tubular basement membrane and trace C3 deposition in the glomerular mesangium, giving a diagnosis of rapid progressive glomerulonephritis. On subsequent follow-up, the sac-like plaques became lax and presented as generalized wrinkling of the skin, raising the question whether cutis laxa and anetoderma are occurring in a spectrum instead as distinct entities. Based on the current review of literature, this is the first reported case of primary anetoderma co-occurring with cutis laxa in a patient with glomerulonephritis. Deposition of immunoglobulins along the elastic fibers could have activated the complement system, mediating the destruction of the elastic fibers, resulting to cutis laxa and anetoderma. This case also considers the possibility of anetoderma and type I acquired cutis laxa occurring either in a spectrum or as distinct diseases in a single patient. Further investigations may identify an ultrastructural pattern that can help differentiate the two entities.

Iatrogenic Anetoderma of Prematurity: A Series of 5 Clinical Cases and Literature Review.

Iatrogenic anetoderma of prematurity (IAOP) represents a benign iatrogenic dermatosis characterized by focal, well-demarcated areas of atrophic skin in preterm infants. We present the cases of 5 infants diagnosed with IAOP during a 3-year period in a tertiary-care university hospital. Skin atrophy patches were absent at birth in all presented infants, and there was no family history of anetoderma. All of the infants were born with very low gestation and birth weight, with a clinical course that was complicated with several serious prematurity-related complications with consequent long periods of unstable vital functions and the need for continuous monitoring. Skin defects consistent with IAOP were located on the previous ECG electrode sites. IAOP changes in all the infants were in the form of oval patches of skin atrophy in the middle chest region, with an additional few small, round patches bellow the nipple on both sides in one girl. Diagnosis of IAOP was based on characteristic clinical findings. IAOP is rare, benign, but permanent skin injury in the most immature of infants, with a potential for considerable aesthetic and psychological burden. Due to the constant increase in survival of very and extremely preterm infants, more often without major developmental consequences, milder complications like IAOP will become more and more important.

Use of dermal fat grafts for treating anetoderma with lipoatrophy following involution of hemangiomas.

Infantile hemangioma (IH) is a benign vascular tumor that gradually involutes over several years. Rapidly involuting congenital hemangioma (RICH) is the relatively rare congenital vascular tumor that is fully grown at birth and does not undergo postnatal growth and involutes during the first year. However, after involution of both IH and RICH, some have severe sequelae, such as redundant skin or conspicuous scarring, requiring additional treatment. We present the case of a 6-year-old girl with a concave deformity due to subcutaneous atrophy, skin darkening, and altered skin texture of her left zygomatic region following involution of a hemangioma. We successfully treated this patient by transferring a dermal fat graft. This technique can be beneficial for atrophic sequelae after regression of a hemangioma and is easy to perform and cosmetically effective.

Anetodermia asociada a síndrome antifosfolipídico / Anetoderma associated with antiphospholipid syndrome

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