1
|
Yang C, Yao L, Zhou L, Qian S, Meng J, Yang L, Chen L, Tan Y, Qiu H, Gu Y, Ding Z, Li P, Liu Z. Mapping port wine stain in vivo by optical coherence tomography angiography and multi-metric characterization. OPTICS EXPRESS 2023; 31:13613-13626. [PMID: 37157245 DOI: 10.1364/oe.485619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Port wine stain (PWS) is a congenital cutaneous capillary malformation composed of ecstatic vessels, while the microstructure of these vessels remains largely unknown. Optical coherence tomography angiography (OCTA) serves as a non-invasive, label-free and high-resolution tool to visualize the 3D tissue microvasculature. However, even as the 3D vessel images of PWS become readily accessible, quantitative analysis algorithms for their organization have mainly remained limited to analysis of 2D images. Especially, 3D orientations of vasculature in PWS have not yet been resolved at a voxel-wise basis. In this study, we employed the inverse signal-to-noise ratio (iSNR)-decorrelation (D) OCTA (ID-OCTA) to acquire 3D blood vessel images in vivo from PWS patients, and used the mean-subtraction method for de-shadowing to correct the tail artifacts. We developed algorithms which mapped blood vessels in spatial-angular hyperspace in a 3D context, and obtained orientation-derived metrics including directional variance and waviness for the characterization of vessel alignment and crimping level, respectively. Combining with thickness and local density measures, our method served as a multi-parametric analysis platform which covered a variety of morphological and organizational characteristics at a voxel-wise basis. We found that blood vessels were thicker, denser and less aligned in lesion skin in contrast to normal skin (symmetrical parts of skin lesions on the cheek), and complementary insights from these metrics led to a classification accuracy of ∼90% in identifying PWS. An improvement in sensitivity of 3D analysis was validated over 2D analysis. Our imaging and analysis system provides a clear picture of the microstructure of blood vessels within PWS tissues, which leads to a better understanding of this capillary malformation disease and facilitates improvements in diagnosis and treatment of PWS.
Collapse
|
2
|
Li X, Diao P, Liu L, Zhou H, Yang Y, Han C, Jiang X. Hematoporphyrin Monomethyl Ether Photodynamic Therapy (HMME-PDT) for the treatment of Sturge-Weber Syndrome and Large Segmental Facial Port-wine Stain. Dermatol Ther 2022; 35:e15404. [PMID: 35199900 DOI: 10.1111/dth.15404] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/25/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023]
Abstract
Hematoporphyrin monomethyl ether (HMME) is a newly authorized photosensitizer for the treatment of port-wine stain (PWS) in China. However, no research on its efficacy for treating PWS lesions of Sturge-Weber syndrome (SWS) has been made. To assess the efficacy and safety of HMME-PDT in the treatment of SWS and simple large segmental facial PWS. Medical records of patients with SWS and large segmental facial PWS were reviewed. Efficacy was evaluated according to colour blanching and graded as excellent (≥75%), good (50-74%), fair (25-49%), and poor (≤24%). Adverse events were analysed. 19 patients with SWS and 33 patients with large segmental facial PWS were analysed. 52.6% SWS and 69.7% PWS patients (P>0.05) achieved at least 25% improvement. Common adverse events included short-term pain, edema, pruritus, exudation, and scab. No severe adverse event occurred. HMME-PDT was effective and safe for SWS and large segmental facial PWS. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Xiaoxue Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Diao
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Liu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Yang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Chenglong Han
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Centre for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Hu Z, Cao J, Choi EY, Li Y. Progressive retinal vessel malformation in a premature infant with Sturge-Weber syndrome: a case report and a literature review of ocular manifestations in Sturge-Weber syndrome. BMC Ophthalmol 2021; 21:56. [PMID: 33482759 PMCID: PMC7821406 DOI: 10.1186/s12886-021-01815-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sturge-Weber syndrome is a disorder marked by a distinctive facial capillary malformation, neurological abnormalities, and ocular abnormalities such as glaucoma and choroidal hemangioma. CASE PRESENTATION We report a case of progressively formed retinal vessel malformation in a premature male infant with Sturge-Weber syndrome and retinopathy of prematurity, after treatment with intravitreal anti-vascular endothelial growth factor (VEGF). The baby was born at 30 weeks gestation with a nevus flammeus involving his left eyelids and maxillary area. On postmenstrual age week 39, he received intravitreal anti-VEGF. Diffuse choroidal hemangioma became evident at 40 weeks, with the classic "tomato catsup fundus" appearance. These clinical findings characterized Sturge-weber syndrome. He presented with posterior retinal vessel tortuosity and vein-to-vein anastomoses at 44 weeks. CONCLUSION This is a rare case of documented progression of retinal vessel malformations in a patient with Sturge-Weber syndrome and retinopathy of prematurity.
Collapse
Affiliation(s)
- Zhengping Hu
- Schepens Eye Research Institute, Mass. Eye and Ear, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jian Cao
- Department of Ophthalmology, The 2nd Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, People's Republic of China
| | - Eun Young Choi
- Schepens Eye Research Institute, Mass. Eye and Ear, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Yun Li
- Department of Ophthalmology, The 2nd Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China. .,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, People's Republic of China.
| |
Collapse
|
4
|
Treatment of haemangiomas using propranolol in paediatric patients: a retrospective cohort study. Postepy Dermatol Alergol 2020; 37:603-607. [PMID: 32994786 PMCID: PMC7507162 DOI: 10.5114/ada.2020.98282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Haemangioma, one of the most common benign neoplasms of early childhood, is a significant clinical problem due to cosmetic reasons but also because of possible health complications. Aim Presentation of the method and results of treatment of infantile haemangiomas (IHs) using propranolol in a maximum dose of 3 mg/kg/day. Material and methods In 2013 to 2018 there were 108 patients with IHs multidisciplinary diagnosed and treated. 77 of them were girls and 31 were boys; all were between the ages of 2 and 21 months (mean: 6.87 months). Lesions were most often located in the head region (n = 73). The main imaging study assessing the arteriovenous flow was USG, which was used to assess the size of haemangioma and its regression or progression. Also, coagulation parameters were analysed using laboratory tests. Results Reduction of lesions occurred in 103 of 108 patients, which results in a percentage score above 95. In 19 patients, after completion of treatment, there were abnormalities of coagulation in laboratory tests whereas before the treatment, these abnormalities occurred in 82 patients. The average duration of treatment was longer than 12 months and the maximum dose of propranolol of 3 mg/kg/day was achieved after 3 to 5 months of treatment. Side effects occurred totally in 19 patients, with night anxiety and nightmares being the most common. Conclusions After achieving the maximum dose of the drug later than recommended in the Recommendation of the Polish Haemangioma and Vascular Malformations Group criteria, there was no need for longer therapy, while the effectiveness of the treatment remained unchanged. Side effects that occurred were not life-threatening or detrimental to the health of patients.
Collapse
|
5
|
Techasatian L, Sanaphay V, Paopongsawan P, Schachner LA. Neonatal Birthmarks: A Prospective Survey in 1000 Neonates. Glob Pediatr Health 2019; 6:2333794X19835668. [PMID: 30956996 PMCID: PMC6442070 DOI: 10.1177/2333794x19835668] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/21/2018] [Indexed: 11/22/2022] Open
Abstract
The majority of neonatal cutaneous conditions are benign and self-limited. However, some skin infections and specific birthmarks are serious and require proper management approaches. This study was a prospective survey of 1000 consecutive newborns at a tertiary care center in Northeast Thailand from September 2015 to 2016, which aimed to identify various cutaneous findings in newborns during their first 5 days of life. The authors found that Mongolian spots (66.7%) and sebaceous gland hyperplasia (60.9%) were the 2 most common cutaneous conditions found in the Thai population. Salmon patches were the most frequent vascular birthmarks (36%), followed by infantile hemangiomas (1.1%) and port wine stains (0.7%). Although majority of the neonatal cutaneous conditions are benign and self-limited, there were 8 cases (0.8%) of bullous impetigo in which both systemic and topical antibiotics were promptly prescribed.
Collapse
Affiliation(s)
- Leelawadee Techasatian
- Dermatology division, Department of Pediatric, Faculty of Medicine, Khon Kaen University, Thailand
| | - Vilounna Sanaphay
- Dermatology division, Department of Pediatric, Faculty of Medicine, Khon Kaen University, Thailand
| | - Pongsatorn Paopongsawan
- Neonatology division, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Thailand
| | - Lawrence A Schachner
- Division of Pediatric Dermatology, Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
6
|
Neerupakam M, Reddy PS, Babu BA, Krishna GV. Sturge Weber Syndrome: A Case Study. J Clin Diagn Res 2017; 11:ZD12-ZD14. [PMID: 28658923 PMCID: PMC5483825 DOI: 10.7860/jcdr/2017/25593.9891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/15/2017] [Indexed: 11/24/2022]
Abstract
The aim of this case review was to touch upon the various clinical presentations and diagnostic features of Sturge-Weber syndrome (SWS) as seen in the dental/medical practice. Sturge-Weber syndrome is a rare congenital disorder that belongs to a group of disorders collectively known as the phakomatoses. The characteristic pathological elements of the disease include leptomeninges angioma extending out to cerebral cortex with angiomatous lesions on the same side and unilateral facial nevus that affects trigeminal nerve division. The classic oral lesions involve haemangiomatous gingival lesion limited on the same side of upper or lower jaw. An 18-year-old female patient reported to the Department of Oral Medicine and Radiology with oral manifestations of SWS. The evaluation of the patient, radiological findings as well as the management is discussed in this case report. It is important for the dental physician to be aware of the non-oral manifestations of SWS in order to identify and manage it appropriately. The challenge here is to see the oral manifestation as part of the syndrome and not as an isolated oral condition. Early diagnosis and appropriate treatment plan is imperative to prevent development of complications.
Collapse
Affiliation(s)
- Mahesh Neerupakam
- Reader, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| | - Podduturi Sanjay Reddy
- Professor, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| | - Beeraboina Anand Babu
- Senior Lecturer, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| | - Guttikonda Vamsi Krishna
- Postgraduate Student, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| |
Collapse
|
7
|
Atteintes ophtalmologiques de l’enfance dans le cadre du syndrome de Sturge-Weber-Krabbe. Arch Pediatr 2017; 24:36-40. [DOI: 10.1016/j.arcped.2016.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 08/16/2016] [Accepted: 10/24/2016] [Indexed: 11/23/2022]
|