Ehlers-Danlos syndrome

Exploring the conditions leading to stoma-forming surgery

The most common disease leading to the formation of a stoma is cancer. However, there are many other diseases that affect the gastrointestinal or urinary system that may also require either a temporary or permanent stoma to be formed (a colostomy, ileostomy or urostomy). Stoma-forming surgery may be undertaken for a number of reasons, such as to eradicate a disease or improve the patient's quality of life. Cancer, inflammatory bowel disease and diverticular disease are the most common conditions that lead to stoma formation. However, faecal incontinence, familial adenomatous polyposis, Hirschsprung's disease, spina bifida and Ehlers-Danlos syndrome may also require a stoma to be formed. The nurse's role in caring for these patients at a potentially traumatic period of their life is discussed.

Abnormal oral mucosal light reflectance: A new clinical sign of Ehlers-Danlos syndrome

Ehlers-Danlos syndrome (EDS) is a major inherited connective tissue disorder leading to an impaired extracellular matrix structure. Although several odontostomatologic signs have been reported, their diagnostic accuracy remains to be ascertained. We tested the hypothesis that EDS is associated with an abnormal reflectance of the oral mucosa. Twelve patients with EDS-II or EDS-III and 12 age- and gender-matched controls were examined. Reflectance of the lower gingival and vestibular oral mucosa in the optical spectrum was measured using an imaging spectrophotometer. EDS patients showed significantly higher reflectance values in the 400-590 nm wavelengths (P<or=.0002) and significantly lower reflectance values in the red wavelengths (610-700 nm range, P<or=.025) than did controls. A reflectance cutoff value of >10.51% at the 400 nm wavelength identified the EDS patients with 100% sensitivity and 100% specificity. These findings indicate that an abnormal oral mucosal reflectance is a previously unrecognized clinical marker of EDS.

Absence of the inferior labial and lingual frenula in Ehlers-Danlos syndrome

The diagnosis of Ehlers-Danlos syndrome is based on distinctive phenotypical characteristics such as hyperelastic skin and hypermobile joints. To date, no congenital physical markers exist for identifying patients with Ehlers-Danlos syndrome. Absence of the inferior labial (100% sensitivity; 99.4% specificity) and lingual frenulum (71.4% sensitivity; 100% specificity) was found to be associated with classical and hypermobility types of Ehlers-Danlos syndrome.