The epidemiological profile of the Vascular Birthmark Clinic at the Alberta Children's Hospital

Fraulin, Frankie Og; Flannigan, Ryan; Sharma, Vishal; McPhalen, Donald F; Harrop, Robertson

doi:10.1177/229255031202000211

Cited by 13 publications

(11 citation statements)

References 9 publications

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“…All patients presenting to the ACH VBM Clinic are entered into the clinic database, which has been previously described (13,14). The children are initially assessed by both a plastic surgeon and pediatrician.…”

Section: Methodsmentioning

confidence: 99%

Beta-blockers for the treatment of problematic hemangiomas

et al. 2013

Canadian Journal of Plastic Surgery

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Objective To examine treatment indications, efficacy and side effects of oral beta-blockers for the treatment of problematic hemangiomas. Methods A retrospective review of patients with hemangiomas presenting to the Alberta Children's Hospital Vascular Birthmark Clinic (Calgary, Alberta) between 2009 and 2011 was conducted. The subset of patients treated with oral beta-blockers was further characterized, investigating indication for treatment, response to treatment, time to resolution of indication, duration of treatment, occurrence of rebound growth and side effects of therapy. Results Between 2009 and 2011, 311 new patients with hemangiomas were seen, of whom 105 were treated with oral beta-blockers. Forty-five patients completed beta-blocker treatment while the remainder continue to receive therapy. Indications for treatment were either functional concerns (68.6%) or disfigurement (31.4%). Functional concerns included ulceration (29.5%), periocular location with potential for visual interference (28.6%), airway interference (4.8%), PHACES syndrome (3.8%), auditory interference (0.95%) and visceral location with congestive heart failure (0.95%). The median age at beta-blocker initiation was 3.3 months; median duration of therapy was 10.6 months; and median maximal treatment dose was 1.5 mg/kg/day for propranolol and 1.6 mg/kg/day for atenolol. Ninety-nine patients (94.3%) responded to therapy with size reduction, colour changes, softened texture and/or healing of ulceration. Rebound growth requiring an additional course of therapy was observed in 23 patients. Side effects from beta-blockers included cool extremities (26.7%), irritability (17.1%), lower gastrointestinal upset (14.3%), emesis (11.4%), hypotension (10.5%), poor feeding (7.6%), lethargy (4.8%), bronchospasm (0.95%) and rash (0.95%). Side effects did not result in complete discontinuation of beta-blocker treatment in any case; however, they prompted a switch to a different beta-blocker preparation in some cases. Resolution of the primary indication, requiring a median time of three months, occurred in 87 individuals (82.9%). Conclusions Treatment of infantile hemangiomas with oral beta-blocker therapy is highly effective and well tolerated, with more than 94% of patients demonstrating a response to treatment and 90% showing resolution of the primary functional indication for treatment.

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Section: Methodsmentioning

confidence: 99%

Beta-blockers for the treatment of problematic hemangiomas

et al. 2013

Canadian Journal of Plastic Surgery

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“… 13 Infantile hemangioma was also more prevalent in female than in male patients, which is consistent with the overall hemangioma data from previous studies conducted in various regions worldwide. 14 – 18 …”

Section: Discussionmentioning

confidence: 99%

Common misdiagnoses and prevalence of dermatological disorders at a pediatric tertiary care center

2019

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Objectives Dermatological disorders are common in general pediatric practice. This study aimed to examine common skin problems and the manner in which they tend to be misdiagnosed. Methods A cross-sectional study was conducted from January 2015 to December 2016 using medical record data from the Pediatric Dermatological Outpatient Unit at Khon Kaen University, Faculty of Medicine. Results A total of 1551 visits by 769 patients were documented during the study period. A total of 114 presenting diseases were recorded. The most common skin disease in the study population was dermatitis (unspecified) (88/769, 11.4%), followed by atopic dermatitis (76/769, 9.8%) and infantile hemangioma (72/769, 9.3%). There was a total of 55 (48.2%) misdiagnosed diseases. Some unique cutaneous diseases were undiagnosed because of their rarity. However, the percentages of common cutaneous diseases, such as tinea capitis and molluscum contagiosum, which had been misdiagnosed, were also high (62.50% [95% confidence interval = 24.49–91.48] and 71.43% [95% confidence interval = 29.04–96.33], respectively). Conclusion A large percentage of misdiagnoses of common cutaneous diseases may be due to general pediatricians being undereducated in the field of dermatology. Accurate recognition and appropriate management of these conditions should be emphasized for educating general pediatricians in the future.

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“…Given the multimodality management of AVMs, surgical planning should be performed in a multidisciplinary setting (1,12) such as the Alberta Children's Hospital Vascular Birthmark Clinic. Treatment must be individualized because of the variable presentation, location and size of AVMs (9).…”

Section: Discussionmentioning

confidence: 99%

Management of a Rare Case of Multiple Arteriovenous Malformations in the Context of Neurofibromatosis Type 2

Beveridge

Fraulin

Amendy

2015

Plastic Surgery Case Studies

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The present article describes a 15-year-old girl with two arteriovenous malformations (AVMs) — on her left labia majora and left thigh — in association with genetically confirmed de-novo neurofibromatosis type 2. This patient's labia majora AVM was particularly difficult to treat using embolization techniques. She experienced numerous complications including pulmonary edema, venous thromboemboli, severe local area necrosis and a damaged anal sphincter. She required surgical debridement and reconstruction of her suprapubic and perineal regions. The left thigh AVM was later treated using a combination of embolization and surgical resection with no complications. Six years later, she is doing well. To the authors’ knowledge, the present report is the only case of neurofibromatosis type 2 associated with extracranial arteriovenous malformations described in the literature.

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The epidemiological profile of the Vascular Birthmark Clinic at the Alberta Children's Hospital

Abstract: Hemangiomas and vascular malformations can occur at any anatomical site. There is a large variation in clinical presentation necessitating expertise in a variety of diagnostic approaches and treatment modalities. Vascular anomalies are best managed in a multidisciplinary setting.

Cited by 13 publications

References 9 publications

Beta-blockers for the treatment of problematic hemangiomas

Beta-blockers for the treatment of problematic hemangiomas

Common misdiagnoses and prevalence of dermatological disorders at a pediatric tertiary care center

Management of a Rare Case of Multiple Arteriovenous Malformations in the Context of Neurofibromatosis Type 2

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