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Dermatological manifestations of pulmonary and neurological emergencies
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Jatinder Singh, Rajan Singh Grewal
Similarly, eosinophilic granulomatosis with polyangiitis or Churg-Strauss syndrome can also present as an acute asthmatic attack with vasculitis lesions, urticaria, and reticulate erythema (livedo reticularis). As many as 70% of patients with Churg-Strauss syndrome have cutaneous manifestations. A variety of lesions may be seen, the most common of which are palpable purpura, subcutaneous nodules, urticarial rashes, and livedo reticularis [17]. Pulmonary arteriovenous malformations (PAVMs): Acute dyspnea, hemoptysis, or rarely hemothorax may be the initial presentation of PAVMs. In almost 70% of cases, PAVMs is associated with hereditary hemorrhagic telangiectasia (HHT), also termed Osler–Weber–Rendu syndrome, characterized by mucocutaneous macular telangiectasia with 1–3 mm of diameter that generally appear 10–30 years after epistaxis episodes (two-thirds of patients) [18]. Palms and fingers are the only sites affected in 71% of patients, whereas lips and tongue involvement are seen in 66% [18]. The mucosal lesions usually blanch on pressure and are highly vulnerable to spontaneous rupture and cause bleeding [19].Anaphylaxis: This is a very common medical emergency worldwide that invariably presents with cutaneous flushing and urticaria in addition to dyspnea and hypotension.
Demographic and Multimodal Imaging Features of Macular Telangiectasia Type 2: Korean Macular Telangiectasia Type 2 Study – Report No. 2
Published in Ophthalmic Epidemiology, 2021
Young Ho Kim, Yoo-Ri Chung, Jaeryung Oh, Seong-Woo Kim, Christopher Seungkyu Lee, Cheolmin Yun, Boram Lee, So Min Ahn, Eun Young Choi, Sungmin Jang, Kihwang Lee
This was a cross-sectional retrospective multicentre observational case series, named the Korean Macular Telangiectasia Type 2 Study. We reviewed the medical records of 131 patients diagnosed as having MacTel from the datasets of six hospitals in Korea from January 2009 to May 2019. The following hospitals participated in this study, and the Institutional Review Board (IRB) of each participating hospital approved this study which is listed in acknowledgment: Ajou University Hospital (Suwon), Korea University Anam Hospital (Seoul), Korea University Guro Hospital (Seoul), Korea University Ansan Hospital (Ansan), Severance Hospital (Seoul), and Gangnam Severance Hospital (Seoul). This study complied with the tenets of the Declaration of Helsinki, and the informed consent was waived by the IRB of each hospital given the retrospective nature of the study.
Evaluation of Choroidal Thickness in Patients with Proliferative and Non-Proliferative Macular Telangiectasia Using Enhanced Depth Imaging Optical Coherence Tomography
Published in Current Eye Research, 2020
Gokhan Demir, Ihsan Cakir, Zeynep Alkin, Ali Demircan, Beril Tulu, Korhan Fazıl
Macular telangiectasia (MacTel) type 2 is a bilateral disease that generally emerges throughout the sixty years of life. The disease firstly presents itself with the loss of retina transparency that starts in the perifoveal region and then surrounds the fovea.1 Advances in imaging modalities have led to the understanding of the disease pathogenesis and morphological sequence. Autofluorescence demonstrates the decreasing normal foveal hypoautofluorescence.2 Fluorescein angiography (FA) reveals telangiectatic juxtafoveal capillaries in the early phase and increasing diffuse hyperfluorescence in the late phase.3,4 Spectral domain optical coherence tomography (SD-OCT) imaging demonstrated structural abnormalities including inner and outer lamellar cavities, disruption of the line representing the inner segment/outer segment (IS/OS), thinning of the central and paracentral retina, outer retinal hyperreflective spots and highly reflective areas consistent with intraretinal pigment migration, formation of hyporeflective inner retinal spaces and pseudolamellar macular holes.5
Multimodal imaging in perifoveal exudative vascular anomalous complex with co‐existent diabetic retinopathy
Published in Clinical and Experimental Optometry, 2019
Ramesh Venkatesh, Naresh K Yadav, Bharathi Bavaharan, Vishma Prabhu, Shivani Sinha
The pathogenesis of PEVAC is not very well known. Focal and progressive retinal endothelial cell injury, as hypothesised by Sacconi et al.,2017 is what may be responsible for the PEVAC lesion formation and its unresponsiveness to anti‐VEGF therapy. PEVAC is often confused with type 1 macular telangiectasia, which usually affects young patients and is associated with intraretinal microangiopathy affecting both the superficial and deep capillary plexus, and associated with cystoid macular oedema and lipid deposition.2006 Moreover, type 1 macular telangiectasia typically responds to anti‐VEGF treatment.2008 By contrast, PEVAC typically affects elderly patients and is characterised by an isolated and well‐defined aneurysmal abnormality, with rarefaction of the retinal capillaries in the perilesional area, but without adjacent capillary aneurysms and/or telangiectasia.