A non-healing perianal ulceration

IF 1.6 4区 医学 Q2 PEDIATRICS Journal of paediatrics and child health Pub Date : 2024-09-03 DOI:10.1111/jpc.1_16570
Chon-Wai J Chan, Samuel A Der Sarkissian, Li-Chuen F Wong, Ali Moghimi, Juliana Puppi
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Abstract

This patient has a variation of haemangioma known as infantile haemangioma with minimal or arrested growth presenting as a non-healing perianal ulceration. The diagnosis was confirmed by skin biopsy demonstrating strong diffuse positive GLUT1 immunostaining at the endothelial lining of the dermal vessels.1, 2 The arrested growth pattern explains the atypical appearance and the ulceration in the perianal area can possibly be explained by the fact that the early developing lesion is irritated by urine and faeces and traumatised by the necessary cleaning of the area.3-5 The perianal ulceration showed a rapid response with complete healing within 4 months of propranolol initiation (Fig. 1b). The morphology and location posed a diagnostic dilemma and required multidisciplinary evaluation to exclude alternate pathologies, including infantile inflammatory bowel disease, immunodeficiency disorders, a large segmental haemangioma and LUMBAR syndrome. This case highlights the importance of including infantile haemangioma among the differential diagnoses in neonates presenting with rapid onset perianal ulceration.

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肛周溃疡无法愈合
这名患者患有一种变异型血管瘤,被称为婴儿血管瘤,其生长微弱或停止,表现为肛周溃疡不愈合。皮肤活检显示真皮血管内皮弥漫性强阳性 GLUT1 免疫染色,从而确诊了该病。1, 2 生长停滞模式解释了该病的非典型外观,而肛周溃疡可能是由于早期病变受到尿液和粪便的刺激,并在必要的清洁过程中受到创伤。3-5 肛周溃疡反应迅速,在服用普萘洛尔后 4 个月内完全愈合(图 1b)。肛周溃疡的形态和位置造成了诊断上的难题,需要进行多学科评估以排除其他病变,包括婴儿炎症性肠病、免疫缺陷疾病、大片状血管瘤和 LUMBAR 综合征。本病例强调了在新生儿出现快速发作的肛周溃疡时,将婴儿血管瘤列入鉴别诊断的重要性。
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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
487
审稿时长
3-6 weeks
期刊介绍: The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.
期刊最新文献
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