Publications by authors named "Leelawadee Techasatian"

18 Publications

  • Page 1 of 1

Hand Hygiene Habits and Prevalence of Hand Eczema During the COVID-19 Pandemic.

J Prim Care Community Health 2021 Jan-Dec;12:21501327211018013

Khon Kaen University, Khon Kaen, Thailand.

Purpose: This study aimed to explore the prevalence of and possible risk factors for hand eczema with respect to the dissemination of information about new hand hygiene habits to protect against ongoing COVID-19 cross-transmission. The authors conducted a survey among health care workers (HCWs) and non-HCW populations in Khon Kaen, Thailand.

Results: A total of 805 participants participated. The prevalence of hand eczema in the study population was 20.87%. There were several risk factors, including working as a HCW, having a history of previous hand eczema, having underlying atopic dermatitis, wearing gloves in everyday life, and washing hands frequently (more than 10 times/day). Hand hygiene with alcohol-based products was shown to be a risk factor for hand eczema, (OR (95% CI) 1.86 (1.03-3.35),  = .04).

Conclusion: In terms of hand eczema prevention, we suggest that the use of alcohol-based products should be discontinued if other handwashing methods are available. The following factors increase the risk of hand eczema: being a HCW, having previous hand eczema, and having underlying atopic dermatitis. Proper strategies in terms of hand eczema prevention should be addressed, especially in this group, since we need to continue performing hand hygiene during the ongoing COVID-19 pandemic.
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http://dx.doi.org/10.1177/21501327211018013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138294PMC
May 2021

Pediatric Anaphylaxis: Etiology and Predictive Factors in an Emergency Setting.

Glob Pediatr Health 2021 29;8:2333794X211011301. Epub 2021 Apr 29.

Pediatrics Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Anaphylaxis is a serious allergic life-threatening condition that needs immediate treatment to prevent unfavorable outcomes. The present study revealed that the prevalence of anaphylaxis in children increased with age and the adolescent group has the most frequent anaphylaxis events. Food-induced anaphylaxis was the most common cause of anaphylaxis in pediatric population. This etiology revealed a significant correlation with a known history of food allergy in the study population,  = .029. Anaphylaxis from insect stings associated with cardiovascular symptoms,  < .001 and inclined to be severe. Univariate analysis showed predicted probability of severe anaphylaxis increased with age with an odds ratio of 1.1. This finding strengthens and supports the view that physicians should be aware of severe anaphylaxis reactions in older age group when there is a documented history of insect sting. The overall pediatric anaphylaxis patients in the study population had favorable outcomes. The authors recommended at least 24 hours hospital observation in order to observe biphasic reaction in pediatric anaphylaxis especially in adolescent age group.
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http://dx.doi.org/10.1177/2333794X211011301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111268PMC
April 2021

Neonatal Birthmarks at the 4 Central Hospitals in Vientiane Capital, Lao PDR.

Glob Pediatr Health 2021 27;8:2333794X21990908. Epub 2021 Jan 27.

Khon Kaen University, Khon Kaen, Thailand.

Newborn skin disorders are quite common and happen to occur during the neonatal period. Most of the birthmarks are transient; however, worried parents often seek medical advice from their child's physician regarding skin lesions. Thus, it is important to differentiate the skin lesions from pathologic ones to avoid unnecessary diagnostic or therapeutic procedures. This is the first published study in Lao neonates that carried out the data from 4 central hospitals in Vientiane Capital, Lao PDR from September 2019 to February 2020. Among 500 neonates, Sebaceous gland hyperplasia (53%), Mongolian patches (46.6%), and Erythema toxicum neonatorum (30%) were the 3 most common cutaneous conditions found in the Lao newborns. From a clinical point of view, these findings are often a source of parental anxiety and medical concern for inexperienced clinicians.
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http://dx.doi.org/10.1177/2333794X21990908DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868484PMC
January 2021

Etiological and predictive factors of pediatric urticaria in an emergency context.

BMC Pediatr 2021 02 19;21(1):92. Epub 2021 Feb 19.

Critical care and Pulmonology Division, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Background: Urticaria is common in pediatric population and is caused by various etiologies which usually differ among different age groups. The different etiologies require different management strategies. Thus, understanding detailed of the etiologies of urticaria in children would help pediatricians to perform appropriate initial treatment.

Methods: A cross-sectional epidemiological study of all patients aged under 18-year-old with the diagnosis of urticaria from any causes entered in the emergency department during January 1st, 2016 to December 31st, 2019 by collecting the data from the Health Object Program®, an authorized electronic medical records program, at the Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.

Results: There were total of 515 urticaria patients aged under 18 years old at the emergency department. The ages of patients ranged from 8 months to 18 years with a median age of 7 years (IQR 3.17-12.08). The majority of the patients were in the preschool-aged group (40.97%), followed by the school-aged (28.16%), adolescent (22.14%), and infant (8.74%). Six major etiologic categories were identified in the present study. The most common cause of urticaria was infection (51.26%), followed by idiopathic urticaria (34.37%), inhalants (6.99%), drugs (4.08%), foods (2.52%), and insect stings (0.78%).

Conclusions: Having underlying allergic diseases had a strong association with all identified causes of urticaria in the study population, of which, food and inhalation etiologies had a significant difference when compared to the other identified causes. The present study has found that infection was the most common cause of acute urticaria in children. This etiology (infection-induced urticaria) usually presents concurrent with fever, however, non-febrile symptoms were also presented. Therefore, in the pediatric population, pediatricians should always look for infection as the cause of urticaria even in patients without pyrexia.
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http://dx.doi.org/10.1186/s12887-021-02553-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892759PMC
February 2021

The Effects of the Face Mask on the Skin Underneath: A Prospective Survey During the COVID-19 Pandemic.

J Prim Care Community Health 2020 Jan-Dec;11:2150132720966167

Khon Kaen University, Khon Kaen, Thailand.

Purpose: The study aimed to explore the prevalence and possible risk factors to prevent the face mask related adverse skin reactions during the ongoing COVID-19 after a recommendation of face mask wearing for public use in Thailand.

Results: The prevalence of face mask related adverse skin reactions was 454 cases (54.5%), of which acne was the most frequent (399; 39.9%), followed by rashes on the face (154; 18.4%), and itch symptoms (130; 15.6%). Wearing a surgical mask showed a higher risk of adverse skin reaction compared to a cloth mask, OR (95% CI) = 1.54 (1.16-2.06). A duration of face mask wearing of more than 4 hours/day and the reuse of face masks increased the risk of adverse skin reactions compared to changing the mask every day, adjusted OR(95% CI) = 1.96 (1.29-2.98), and 1.5 (1.11-2.02).

Conclusion: Suggestions were made for wearing a cloth mask in non-health care workers (HCW) to decrease the risk of face mask related adverse skin reactions. This suggestion could potentially help in decreasing the demand of surgical masks which should be reserved for the HCW population during the ongoing COVID-19 pandemic.
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http://dx.doi.org/10.1177/2150132720966167DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786409PMC
October 2020

Diaper rashes can indicate systemic conditions other than diaper dermatitis.

BMC Dermatol 2020 09 21;20(1). Epub 2020 Sep 21.

Pediatric Department, Dermatology Division, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.

Background: Although the majority of rashes in the diaper area are caused by irritation from urine and feces, irritant diaper dermatitis; IDD, there are some less common but potentially serious cutaneous eruptions associated with systemic diseases that should not be discounted.

Methods: This prospective descriptive study aimed to explore variation in cutaneous disease in the diaper area. It was conducted as a prospective descriptive study between October 2016 and November 2019 in the pediatric department of a tertiary-level hospital.

Results: Three hundred consecutive patients with rashes in the diaper area were enrolled. The most common diagnosed was IDD (125 cases; 41.7%), followed by rashes exacerbated by the diaper (101 cases; 33.67%) and non-diaper-related rashes (74 cases; 24.67%).

Conclusions: Our finding suggests that when diagnosing rashes that occur in the diaper area, general pediatricians should consider, in addition to IDD, the possibility of less-common conditions. The simultaneous presence of cutaneous lesions at other sites was linked to diagnoses of systemic diseases other than IDD, (P < 0.001).
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http://dx.doi.org/10.1186/s12895-020-00104-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507743PMC
September 2020

Diaper Dermatitis: Prevalence and Associated Factors in 2 University Daycare Centers.

J Prim Care Community Health 2020 Jan-Dec;11:2150132719898924

Khon Kaen University, Khon Kaen, Thailand.

Diaper dermatitis is uncommon in children older than 2 years because the majority of these children are diaper independent. However, diaper dermatitis still occurs, especially in children in daycare settings. This study attempted to determine the prevalence of diaper dermatitis and its associated factors among children aged 2 to 4 years attending daycare centers. Cross-sectional analysis and tests for correlation were conducted to determine the factors associated with diaper dermatitis among the study population. The prevalence of diaper dermatitis during the study period was 17.2%. Factors significantly correlated with the occurrence of diaper dermatitis were beginning toilet training later than 2 years of age (odds ratio [OR] = 2.84, 95% CI = 1.17-6.86, = .02) and the use of oral antibiotics (OR = 15.92, 95%CI = 3.57-70.94, < .001). Two major adjustable factors for preventing diaper dermatitis in the study population were toilet training before 2 years of age and avoiding the use of unnecessary oral antibiotics. These results may help in devising a preventive protocol for diaper dermatitis among this age group in the future.
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http://dx.doi.org/10.1177/2150132719898924DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956600PMC
January 2020

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

J Int Med Res 2020 Feb 19;48(2):300060519873490. Epub 2019 Sep 19.

Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

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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http://dx.doi.org/10.1177/0300060519873490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593671PMC
February 2020

Diaper dermatitis: a survey of risk factors in Thai children aged under 24 months.

BMC Dermatol 2019 07 2;19(1). Epub 2019 Jul 2.

Dermatology Division, Pediatric Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.

Background: To identify the prevalence and risk factors associated with diaper dermatitis in Thai children aged 1-24 months.

Methods: This was a cross-sectional study of 1153 participants using structural questionnaires, which was conducted at Khon Kaen University Faculty of Medicine Pediatric department in Thailand. Univariate and multivariate logistic regression analyses were used to test the association between diaper dermatitis and its possible risk factors.

Results: The prevalence of diaper dermatitis among the study population was 36.1%, a rate which significantly decreased with age. The highest prevalence was found in subjects who were one to six months old. Risk factors that had a statistically significant association with diaper dermatitis in both univariate and multivariate analysis were i) diaper changing fewer than three times/night, ii) previous episodes of diaper rash, iii) using cloth diapers, and iv) topical application of baby talcum powder to the diaper area.

Conclusions: Frequent diaper changings during the daytime do not compensate for fewer changings during the night. Moreover, the use of baby talcum powder on the diaper area significantly increased the risk of diaper dermatitis among the study population. These findings should be applied in future preventive strategies for diaper dermatitis in this age group.
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http://dx.doi.org/10.1186/s12895-019-0089-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604136PMC
July 2019

Neonatal Birthmarks: A Prospective Survey in 1000 Neonates.

Glob Pediatr Health 2019 29;6:2333794X19835668. Epub 2019 Mar 29.

Division of Pediatric Dermatology, Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

The majority of neonatal cutaneous conditions are benign and self-limited. However, some skin infections and specific birthmarks are serious and require proper management approaches. This study was a prospective survey of 1000 consecutive newborns at a tertiary care center in Northeast Thailand from September 2015 to 2016, which aimed to identify various cutaneous findings in newborns during their first 5 days of life. The authors found that Mongolian spots (66.7%) and sebaceous gland hyperplasia (60.9%) were the 2 most common cutaneous conditions found in the Thai population. Salmon patches were the most frequent vascular birthmarks (36%), followed by infantile hemangiomas (1.1%) and port wine stains (0.7%). Although majority of the neonatal cutaneous conditions are benign and self-limited, there were 8 cases (0.8%) of bullous impetigo in which both systemic and topical antibiotics were promptly prescribed.
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http://dx.doi.org/10.1177/2333794X19835668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442070PMC
March 2019

Diverse cutaneous manifestation of Langerhans cell histiocytosis: a 10-year retrospective cohort study.

Eur J Pediatr 2019 May 2;178(5):771-776. Epub 2019 Mar 2.

Dermatology Division, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.

Cutaneous manifestation is a common presentation of LCH and is usually a leading clue for the disease diagnosis. Having cutaneous lesions did not show a significantly early age onset at diagnosis compared to those without skin lesions, P value = 0.71. In the present study, cutaneous findings were found as 77.7%. Seborrheic dermatitis-like lesions were the most common cutaneous type (42.8%), followed by papules/nodules/masses (28.5%), petechiae/hemorrhagic lesions (17.8%), and eczematous lesions (10.7%). Time to diagnosis of LCH presented with seborrheic dermatitis-like lesions was significantly longer than other cutaneous presentations, P value = 0.0011.Conclusion: Patients with LCH who had the manifestations of seborrheic dermatitis-like lesions can have diagnosis delayed due to the difficulty in distinguishing these lesions from normal seborrheic dermatitis lesions. Petechiae/hemorrhagic cutaneous signs in addition to the normal seborrheic dermatitis is the clue for early detection of the disease. To improve early detection of LCH, general pediatricians should be alerted to be aware of these skin symptoms, and if they persist, a dermatologist, pediatric if available, should be immediately consulted. What is Known? • Cutaneous manifestation is a common presentation of LCH and is usually a leading clue for the disease diagnosis. What is New? • Patients with LCH who have the manifestations of seborrheic dermatitis-like lesions can have a delayed diagnosis due to the difficulty in distinguishing normal from seborrheic dermatitis lesions. • Petechiae/hemorrhagic cutaneous signs in addition to the normal seborrheic dermatitis are the clue to the early disease detection.
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http://dx.doi.org/10.1007/s00431-019-03356-1DOI Listing
May 2019

Multiple yellow-red papules on the head and neck in a 3-month-old boy.

Pediatr Int 2017 Jan;59(1):118-119

Pathology Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

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http://dx.doi.org/10.1111/ped.13191DOI Listing
January 2017

Drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children: 20 years study in a tertiary care hospital.

World J Pediatr 2017 Jun 20;13(3):255-260. Epub 2016 Sep 20.

Pediatric Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe lifethreatening skin conditions. The most common cause of these manifestations is medications. Beside discontinued of the culprit drug, systemic corticosteroids were used as a primary treatment option among pediatric population. This study aimed to explore causative drugs (drug group/ latent period), treaments, complications, and treatment outcome (morbidity, mortality, length of hospital stay) of SJS and TEN in children.

Methods: A retrospective chart was reviewed during the period of 1992 to 2012 at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. SJS and TEN were clinically diagnosed and confirmed by pediatric dermatologists. Other possible causes other than druginduced SJS and TEN were excluded.

Results: A total of 30 patients was recorded, including 24 (80%) SJS patients and 6 (20%) TEN patients. The mean age was 6.9 years (SD 4.4). Male to female ratio was 1.5:1. Antiepileptic drug group was the most common causative drug (n=18, 60%), followed by antibiotic drug group (n=8, 26.6%), and others (n=4, 13.3%) which included nonsteroidal antiinflammtory drugs (NSAIDs) and chemotherapy drugs. Systemic corticosteroids were used in 29 patients (96.6%). Intravenous immunoglobulin was used in one TEN patient (3.3%). There was a medium correlation between time to treatment (systemic corticosteroids) and the length of hospital stay (Spearman correlation coefficient=0.63, P=0.005). Two TEN patients (6.6%) died.

Conclusions: Carbamazepine was the most common causative drug of SJS and TEN in our study. The severity of skin detachment is not correlated to severity of ocular findings. However, the persistent of ocular complications up to one year is suggested for promptly appropriate ocular treatment in all SJS and TEN patients. Our data suggested that early administration of systemic corticosteroid may reduce the length of hospital stay and should be considered for the treatment of pediatric druginduced SJS and TEN.
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http://dx.doi.org/10.1007/s12519-016-0057-3DOI Listing
June 2017

Treatment Modalities and Outcomes of Infantile Hemangiomas at Srinagarind Hospital.

J Med Assoc Thai 2016 Aug;99 Suppl 5:S74-80

Background: There are many treatment modalities for infantile hemangiomas. During the past decades, systemic corticosteroid was the mainstay therapy in this condition. However, the most recent option of using oral propranolol has been considered as a first line therapy instead of systemic corticosteroid. On the other hand, there are still many treatment modalities which can be used as an alternative option in treating this condition.

Objective: To explore the epidemiology of infantile hemangiomas, treatment modalities and outcomes at Srinagarind Hospital during 2004-2014.

Material And Method: Retrospective chart reviewed from the out patient clinic’s database at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.

Results: There were a total of 154 infantile hemangiomas. Female to male ratio was 1.8:1. The most common locations of infantile hemangiomas were head and neck areas (69.0%), followed by extremities (21.0%) and trunk (10.0%). Treatment modalities for infantile hemangiomas during the past 10 years (based on initial approaches) were oral propranolol (57.1%), oral prednisolone (17.5%), surgery (10.4%), interferon alpha (9.8%), vincristine (4.5%) and laser (0.6%). All treatment modalities showed high efficacy in treating this condition.

Conclusion: There are many effective treatment modalities for infantile hemangiomas. Even though oral propranolol has become the first line therapy in this condition, other treatment options are still effective and useful, especially with those unresponsive to oral propranolol.
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August 2016

Propranolol was effective in treating cutaneous infantile haemangiomas in Thai children.

Acta Paediatr 2016 Jun 8;105(6):e257-62. Epub 2016 Apr 8.

Division of Dermatology, Department of Pediatric, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Aim: The aim of this study was to explore the efficacy and safety of propranolol in treating infantile haemangiomas, the most common benign vascular tumours in children.

Methods: We carried out a retrospective chart review of infantile haemangioma patients admitted to the Faculty of Medicine, Khon Kaen University, Thailand, from January 2009 to January 2015.

Results: There were 53 infantile haemangioma cases treated with oral propranolol. Treatment responses occurred as early as two weeks after propranolol administration in 91.5% of the follow-up patients, with all 53 cases achieving the desired treatment responses two months after propranolol was initiated. No significant differences in treatment responses were found between propranolol as a mono-therapy or as a combination therapy with prednisolone at the two-week (p value 0.13) and one-month follow-ups (p value 0.98). Complications were documented in three cases (5.6%) when the propranolol dose was increased, and these were asymptomatic hypoglycaemia in two cases and one case of hypotension.

Conclusion: Propranolol was effective in treating infantile haemangiomas, and combining it with prednisolone achieved no significant differences in treatment outcome. Cases should be monitored for hypoglycaemia and hypotension. More data on using propranolol for infantile haemangiomas are needed, including long-term follow-up studies.
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http://dx.doi.org/10.1111/apa.13378DOI Listing
June 2016

Hematidrosis: a report with histological and biochemical documents.

Int J Dermatol 2016 Aug 11;55(8):916-8. Epub 2016 Jan 11.

Hematology Division, Pediatric Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

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http://dx.doi.org/10.1111/ijd.13214DOI Listing
August 2016

Carbamazepine-Induced Incomplete Stevens-Johnson Syndrome: Report of a Case in Children without Mycoplasma pneumoniae Infection.

J Med Assoc Thai 2015 Aug;98 Suppl 7:S243-7

Incomplete Stevens-Johnson syndrome (SJS) is a rare reactive skin condition. Most cases are occurred in children and all are associated with Mycoplasma pneumoniae (M. pneumoniae) infection. We reported an unusual case of a 6-year-old boy who developed the presentation of isolated mucosal erosion with a lack of skin findings, which indicated incomplete SJS after two weeks of carbamazepine (CBZ) administration. Findings of positive HLA-B*1502 allele supported a possible causative influence of carbamazepine inducing SJS. Interestingly, this patient was tested negatively for M. pneumoniae. This is a significant finding since there is no previous report of incomplete SJS without M. pneumoniae infection. Discontinuation of CBZ and administration of systemic corticosteroids were accomplished to treat SJS, which resulted in complete recovery. Our interesting findings highlighted the manifestation of incomplete SJS, which can present with other causes rather than M. pneumoniae infection. Early manifestation of mucosal change without typical skin lesions should not be neglected in the diagnosis of incomplete SJS.
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August 2015

Vascular Anomalies: The Epidemiological Profile at Srinagarind Hospital.

J Med Assoc Thai 2015 Aug;98 Suppl 7:S101-6

Background: Vascular anomalies or vascular birthmarks can be divided in to 2 major groups: (i) vascular tumors and (ii) vascular malformations. Currently, there are many treatment modalities for these diseases and the treatment plans are varied among sub-specialty physicians.

Objective: To explore the epidemiology of vascular anomalies at Srinagrind Hospital during 2009-2011.

Material And Method: Retrospective chart was reviewed from the out patient clinic's database at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.

Results: There were total of 126 vascular anomalies cases. 89 cases were diagnosed with vascular tumors and 37 cases were vascular malformations. Among 89 cases of vascular tumors, infantile hemangiomas are the most common type (95.5%). The treatment methods for vascular tumors were medical treatments, which were used in majority of the cases (60%), followed by surgical excision, laser treatment, intralesional corticosteroids injection, and the combination of medical, laser and surgical treatment. There were total of 37 cases of vascular malformations. Most of the cases were venous and lymphatic malformations. Treatment methods for these patients were surgical excision, bleomycin injection, and radiation.

Conclusion: Vascular anomalies have various presentations. Treatment is challenging and multidisciplinary teams are involved in taking care the patients with this entity of disease. Setting up vascular anomalies clinic is essential and suggested for the patients with vascular anomalies' problems.
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August 2015