Infrared light heat therapy of port wine stain in adult patients as new innovative technique

Background: Port wine needs early age intervention, most effectively by pulse dye laser where about 40-45% improves only and by at least 75% after 5 to 25 sessions. Objectives: To try therapy of port wine stain in adult patients using flame of infrared light. Patients and Methods: Twenty adult patients with facial port wine stain were treated during the period from 2014-2017 years, 11 females and 9 males with ages ranged from 16-35 years with a mean of 25 years. After local anesthesia with 2% xylocaine, direct flame of infrared light that generated from heated red head of needle of diathermy was used. This light therapy was delivered with about 1-2cm away from the port wine and the time of exposure was decided by greyish blanching of the lesion, usually 1-2 minutes needed. Only one session of infrared was delivered. The response to therapy and according to the reduction rate was estimated as follow: 0-25%,>26-50%,>51-75%,>76-100%. Results: Immediately after session, there was edema, swelling. Reduction of erythema of port wine started immediately after infrared exposure and was obvious after two weeks and then slowly faded, with more improvement in the next few months. The reduction rate of port wine stain was ranged between 50-70% after only one session in 19 patients while one patient showed 25% reduction. It was noticed that, whenever the color of the port wine stain is dusky red with thickened nodular lesions, it responded quickly and better to this therapy. Conclusion: Infrared light heat therapy from diathermy needle was an effective mode of therapy in all adult patients with port wine stain. This new technique is easy to be used and non -costly procedure especially when compared with pulse dye laser.

Sturge-weber syndrome: Characteristics of facial port wine stain with neurological and ophthalmological deficits

Background: Sturge-Weber Syndrome (SWS) is a neurocutaneous defect involving facial Port Wine Stain (PWS) with vascular deficits in the brain and ipsilateral eyes. Facial PWS can be the initial marker and help predict the severity of SWS. Aims and objectives: To study the association of facial PWS characteristics, neurological and ophthalmological deficits in SWS with the degree of severity. Materials and Methods: A retrospective descriptive study of patients with SWS was conducted at Dr. Sardjito Hospital between January 2010 - December 2020. Facial PWS characteristics were assessed from photographs. Assessments of neurological and ophthalmological deficits used physical and supportive examinations, including Electroencephalogram (EEG), Magnetic Resonance Imaging (MRI), and Intelligent-Quotient (IQ). Results: From 19 female patients aged 1 month to 26 years with facial PWS, seven fulfilled the inclusion criteria. “High risk” facial PWS V1 and P1 b distribution patterns were found in all patients. Most patients had neurological deficits of rare focal seizures (83%). Fine motor disorders (50%) were the most severe motoric deficits found. All patients experienced glaucoma with decreased visuality to blindness and hemianopsia. EEG epileptiform patterns, MRI showing angiomatosis and brain atrophy, and low IQ scores were recorded. Conclusions: Pathogenesis and degree of severity in SWS were related to facial PWS, neurological and ophthalmological deficits. Keywords: Sturge-weber syndrome; facial port-wine stain; neurological deficit; ophthalmological deficit; neurocutaneous disorder.

Pyogenic granuloma arising within capillary malformations in children: A case report and literature review

Pyogenic granuloma (PG) is an acquired benign vascular hyperplasia. Even though PG is not so rare, its etiology is still unclear. Assuredly, an association between vascular anomalies and PG is an extremely rare finding, and a proper management of these cases is not well standardized to date. Herein, we report our experience with a giant PG arising spontaneously within a port-wine stain of the thorax. Previous cases reported in the pediatric literature and strategies of treatment are also discussed.