Unilateral nevoid telangiectasia—response to long-pulsed Nd:YAG laser and pulsed dye laser: a case report
Bibliographic record
Abstract
Unilateral nevoid telangiectasia (UNT) is a rare disease characterized by punctuate and stellate telangiectasias that follow dermatomal distribution.1 Its etiology remains elusive; no standard treatment currently exists. We describe a 14-year-old Asian female (skin type IV) with UNT, who underwent treatment with long-pulsed 1064-nm Nd:YAG laser and 595-nm pulsed dye laser for her disease. The patient came to our clinic with linearly arranged, punctate telangiectasias over right side of back, shoulder, and arm (Figure 1). The lesions appeared at the age of 10. The diagnosis of UNT was made based on the clinical manifestations and telangiectasias in superficial dermis (as shown on a histologic exam done previously at another hospital). Angioma serpiginosum is an important differential diagnosis of UNT in this case. Three sessions of treatment with long-pulsed 1064-nm Nd:YAG laser (GentleYAG Laser; Candela Laser, Wayland, MA, USA) were given with parameters (fluence-spot sizepulse width) of 240 J/cm2-3 mm-10 ms (first week), 240 J/ cm2-3 mm-10 ms (second week), and 280 J/cm2-3 mm-10 ms (third week). The interval between each session was 4 weeks. However, there was only slight improvement. Histologic exam performed 2 weeks after the third session revealed marked telangiectasias in papillary dermis (Figure 2). Next, two sessions of pulsed dye laser with 595 nm wavelength (Vbeam Perfecta; Candela Laser) were given with parameters of 13 J/cm2-7 mm-40 ms (fluence-spot sizepulse width) for both sessions. Significant lightening of lesions (> 90%) was observed after the second session (Figure 3). The only adverse reaction was transient purpura that lasted for approximately 2 weeks. There was no hypoor hyper-pigmentation after treatment. There are two forms of UNT, the rarer congenital form and the more common acquired form.2 Telangiectasia develops during puberty in most of the acquired cases, as in our patient. Several reports point out the systemic association of acquired UNT, such as hyperestrogenemia and chronic liver disease.2 In out patient, there was no evidence of high serum level of estrogen or hepatic disease. Both long-pulsed 1064-nm Nd:YAG laser and pulsed dye laser have been shown to be effective in treating vascular lesions.3,4 Major et al3 reported good response with the former for facial and leg telangiectasias. However, it does not seem to be a good treatment modality for UNT for the current case. One possible explanation is that while the 1064-nm Nd:YAG laser beam tends to penetrate to deeper dermis, due to its long wavelength and lesser absorption Figure 1 Clinical picture before treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".