The term mastocytosis refers to a heterogeneous group of disorders characterised by accumulation of clonal mast cells in different organs, most commonly in the skin. Little is known about the role of dermoscopy in the diagnostics of mastocytosis. To date, no systematic review on the dermoscopic features of cutaneous mastocytosis has been performed. The aim of this study was to summarise the current knowledge in the field as well as to identify the knowledge gaps to show possible directions for further studies, based on a systematic search of PubMed, Scopus, and Web of Science databases and related references published before 3 January 2022. Dermoscopic features, type of dermoscope, polarisation mode, magnification, and number of cases were analysed. In total, 16 articles were included in this review (3 case series and 13 case reports), analysing 148 patients with different variants of cutaneous mastocytosis; all of the studies analysed had a low level of evidence (V). The main dermoscopic features of urticaria pigmentosa included brown structureless areas, brown lines arranged in a network, and linear vessels distributed in a reticular pattern, with this last finding also being typical of telangiectasia macularis eruptiva perstans. The presence of either circumscribed yellow structureless areas or diffuse yellowish background was a constant pattern of mastocytoma, while nodular, pseudoangiomatous xanthelasmoid, and plaque-type mastocytosis were typified by light-brown structureless areas and/or pigment network, though the first two variants also showed yellow/yellow-orange structureless areas. Finally, pigmented streaks of radial distribution surrounding hair follicles were described to be a pathognomonic dermoscopic feature of pseudoxanthomatous mastocytosis. Although this review shows that the various clinical forms of cutaneous mastocytosis may feature diagnostic dermoscopic clues, it also underlines the need for further investigation as several relevant data are missing, including evaluation of dermoscopic pattern according to anatomical locations or “lesion age”, studies on rare mastocytosis variants, evaluation of the prognostic role of dermoscopy in the context of systemic involvement, and comparative analyses with common clinical mimickers.
Long-term ECG is widely used in diagnosis and assessment of many cardiac symptoms which may be caused by dangerous arrhythmias that sometimes can be difficult to document. The PocketECG system is a new technological solution for a long-term, noninvasive, continuous and real-time ECG monitoring that provides automatic diagnosis of dysrhythmias. ECG data transmission occurs over a mobile network. The goal of this study was to assess the reliability of long-term ECG recordings acquired with the PocketECG system. One hundred and fifteen patients (43 girls and 72 boys) of an average age of 15.5 ± 2.5 years were examined at the Department of Cardiology at the Children's Memorial Health Institute. Two simultaneous 24-h ECG recordings were conducted: one with a Holter monitor and one with the PocketECG system. A linear correlation was demonstrated between the two methods with regard to the recorded QRS complexes [H = 1173.0 (-1946.40; 4838.50) + PocketECG*0.98 (0.94; 1.02)]. Mean diurnal heart rhythms were comparable (p > 0.05) despite the fact that the slowest and the fastest rates were different. The rate of detection for ventricular, supraventricular dysrhythmias and pauses in ventricular rhythm were comparable in both methods. The PocketECG system for continuous and real-time ECG recording is a reliable method for the assessment of heart rhythm and dysrhythmias in children and adolescents.
Streszczenie Perforacja komory serca jest rzadkim (dotyczy ok. 1% chorych), ale bardzo poważnym powikłaniem, które może wystąpić po wszczepieniu układu kardiostymulującego. Zaprezentowano opis powikłań będących następstwem wszczepienia kardiostymulatora VVI oraz jego wymiany na elektrodę endokawitarną u 81-letniej chorej z blokiem przedsionkowo-komorowym II stopnia. Słowa kluczowe: perforacja komory, jatrogenna tamponada, blok AV Folia Cardiologica 2017; 12, 4: 408-410 Wstęp Częstość występowania komplikacji związanych z wszcze-pieniem stymulatorów serca w ostatnich latach wzrasta. Prawdopodobnie wiąże się to z coraz większą liczbą implantacji złożonych układów stymulujących serce oraz z wiekiem chorych kwalifikowanych do tej procedury, nierzadko obciążonych dużą liczbą schorzeń współtowa-rzyszących [1, 2]. Powikłania związane z wszczepieniem elektrostymulacji można podzielić na wczesne (do 3 mies. po zabiegu) oraz późne [3]. Do powikłań można zaliczyć infekcje (w miejscu wszcze-pienia stymulatora [kieszonka], infekcyjne zapalenie wsierdzia), krwiak w kieszeni stymulatora, stymulację mięśni ściany klatki piersiowej, przepony, drażnienie ner-wu przeponowego, zakrzepicę żyły podobojczykowej lub jej bocznic oraz rzadziej występujące powikłania, niestety często związane z dużym ryzykiem zgonu-perforację pra-wego przedsionka lub prawej komory serca z towarzyszącą tamponadą [4]. Uszkodzenie przegrody międzykomorowej i następnie przebicie elektrodą lewej komory serca jest bardzo rzadkim powikłaniem procedury kardiologicznej wymagającym pilnej interwencji chirurgicznej. Opis przypadku Pacjentka w wieku 81 lat (wskaźnik masy ciała [BMI, body mass index] 16,6 kg/m 2), z blokiem przedsionkowo-komorowym II stopnia, nadciśnieniem tętniczym oraz po histerektomii z powodu mięśniaków macicy w wywiadzie, została przyjęta do kliniki chirurgii ogólnej i transplantacyj-nej w trybie pilnym z powodu podejrzenia krwawienia do jamy brzusznej po interwencjach kardiologicznych. U chorej z powodu bloku przedsionkowo-komorowego wszczepiono stymulator dwujamowy (VVI) z dostępu przez prawą żyłę podobojczykową. Po dobie obserwacji pacjentka
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