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      Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO 2 and Long-Pulsed Nd:YAG Lasers

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          Abstract

          A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO<sub>2</sub> laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO<sub>2</sub> laser and long-pulsed Nd:YAG laser appeared effective for treating LC.

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          Most cited references7

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          Treatment of lymphangioma circumscriptum with combined radiofrequency current and 900 nm diode laser.

          Laser treatment of lymphangioma circumscriptum is a major challenge because of the persistent nature of the disease and the large variations in lesion size, depth, and anatomic location. To determine the safety and effectiveness of electro-optical synergy, a new technology that combines a 900 nm diode laser with radiofrequency current, for the treatment of lymphangioma circumscriptum. Six patients with Fitzpatrick skin types II to IV were treated for lymphangioma circumscriptum with 1 to 3 sessions of simultaneous radiofrequency energy (60-80 J/cm3) and optical diode laser energy (fluence 90-100 J/cm2). Lesion clearance was evaluated by three specialists on the basis of digital photographs taken before the first treatment and 1 and 2 months after the last treatment. Results were rated as "excellent" in four patients and "good" in two patients. Transient swelling, erythema, and pain were present in all patients, and ulcers and scarring in two patients. The combination of laser light and radiofrequency energy is effective and relatively safe for the treatment of lymphangioma circumscriptum. It provides additional heating of the blood vesicles without increasing the laser intensity and allows the clinician to treat the clear lymphatic component, which lacks a specific optical chromophore. Side effects are tolerable.
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            Recurrent vulval congenital lymphangioma circumscriptum--a case report and literature review.

            Lymphangioma circumscriptum (LC) is a defect of lymphatics in deep dermis. This abnormal saccular dilatation of lymphatics occurs in dermal papillae visible as vesicles clinically. The entity may be acquired or congenital. The occurrence of congenital variety of LC in vulva is extremely rare, with only few cases reported in the literature. We communicate one such case presenting as recurrent vulval growth along with a review of literature and treatment modalities.
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              • Article: not found

              Cutaneous Lymphangioma

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                Author and article information

                Journal
                CDE
                CDE
                10.1159/issn.1662-6567
                Case Reports in Dermatology
                S. Karger AG
                1662-6567
                2014
                January – April 2014
                08 January 2014
                : 6
                : 1
                : 1-4
                Affiliations
                aDepartment of Dermatology, Kariya Toyota General Hospital, Kariya, bDepartment of Dermatology, Fujita Health University School of Medicine, Toyoake, and cAoyama Institute of Women's Medicine, Tokyo Women's Medical University, Tokyo, Japan
                Author notes
                *Ryosuke Sasaki, MD, Department of Dermatology, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya 448-8505 (Japan), E-Mail r-sasaki@fujita-hu.ac.jp
                Article
                358006 PMC3934613 Case Rep Dermatol 2014;6:1-4
                10.1159/000358006
                PMC3934613
                24575003
                4a68c5bc-a6ab-42b4-98f9-58ab9eb33d07
                © 2014 S. Karger AG, Basel

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) ( http://www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Page count
                Figures: 3, Pages: 4
                Categories
                Published: January 2014

                Oncology & Radiotherapy,Pathology,Surgery,Dermatology,Pharmacology & Pharmaceutical medicine
                Long-pulsed Nd:YAG laser,Lymphangioma circumscriptum,CO2 laser

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