The Hypersensitivity Syndromes

Paller, Amy S.; Mancini, Anthony J.

doi:10.1016/b978-1-4377-0412-9.00020-4

Cited by 4 publications

(2 citation statements)

References 263 publications

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“…McCune-Albright syndrome is associated with a singular lesion that is characteristically large, unilateral, and with irregular borders . In dermatologic texts, the asymmetric and irregular borders of lesions associated with McCune-Albright syndrome are likened to the coast of Maine, while the smooth borders of those associated with neurofibromatosis are likened to the coast of California …”

Section: Introductionmentioning

confidence: 99%

Response to Laser Treatment of Café au Lait Macules Based on Morphologic Features

et al. 2017

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IMPORTANCEResponse to laser treatment for café au lait macules (CALMs) is inconsistent and difficult to predict. OBJECTIVE To test the hypothesis that irregularly bordered CALMs of the "coast of Maine" subtype respond better to treatment than those of the smooth-bordered "coast of California" subtype. DESIGN, SETTING, AND PARTICIPANTSThis retrospective case series included patients from 2 multiple-clinician US practices treated from 2005 through 2016. All patients had a clinical diagnosis of CALM and were treated with a Q-switched or picosecond laser. A total of 51 consecutive patients were eligible, 6 of whom were excluded owing to ambiguous lesion subtype. Observers were blinded to final patient groupings.EXPOSURES Treatment with 755-nm alexandrite picosecond laser, Q-switched ruby laser, Q-switched alexandrite laser, or Q-switched 1064-nm Nd:YAG laser.MAIN OUTCOMES AND MEASURES Main outcome was grade in a visual analog scale (VAS) consisting of 4 levels of treatment response: poor (grade 1, 0%-25% improvement), fair (grade 2, 26%-50% improvement), good (grade 3, 51%-75% improvement), and excellent (grade 4, 76%-100% improvement).RESULTS Forty-five patients were included in the series, 19 with smooth-bordered lesions and 26 with irregularly bordered lesions. Thirty-four (76%) of the participants were female; 33 (73%) were white; and the mean age at the time of laser treatment was 14.5 years (range, 0-44 years). Smooth-bordered lesions received a mean VAS score of 1.76, corresponding to a fair response on average (26%-50% pigmentary clearance). Irregularly bordered lesions received a mean VAS score of 3.67, corresponding to an excellent response on average (76%-100% clearance) (P < .001). CONCLUSIONS AND RELEVANCECALMs with jagged or ill-defined borders of the coast of Maine subtype tend to respond well to laser treatment, whereas those with smooth and well-defined borders of the coast of California subtype tend to have poor response. Clinicians using Q-switched or picosecond lasers to treat CALMs can use morphologic characteristics to help predict response and more effectively manage patient expectations.

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Section: Introductionmentioning

confidence: 99%

Response to Laser Treatment of Café au Lait Macules Based on Morphologic Features

et al. 2017

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“…Angiokeratomas present as dark red, purple, or black firm, hyperkeratotic papules or verrucous nodules that are 1 to 10 mm . They are usually asymptomatic, but can present with pain in 14% of cases or bleeding in 25% of cases, leading to concern for the development of malignant melanoma .…”

Section: Discussionmentioning

confidence: 99%