Minimal Invasive Method To Treat Hemangiomas Of The Oral Cavity With Co2 Laser

During the last six years we have developed a new CO2 laser technique for the treatment of symptomatic oral cavity hemangioma. Our new technique, named 'laser encircling technique', has especially succeeded during hemangioma buccal maxillary surgeries. The treatment consisted in the application of a line of points of CO2 laser circling the lesion. Depending on the position and size of the lesion, we used from 0.4 to 4.0 Joules/mm2 laser energy density per pulse, causing reduction in the size of the lesion throughout the sclerosis of nutritional vessels which led to reduction in size, volume and color of the hemangiomas with no significant bleeding or inflammatory reaction. In this work forty male and female patients, twelve to fifty years old, presenting medium to small size hemangiomas situated in different sites of the oral cavity such as the tongue, mouth vestibule, pharynx, tonsil area and lips were treated by the procedure described above. The number of laser applications was defined by the peculiarities of each case, varying form 3 to 6 sessions at 4 week intervals, always under local or topic anesthesia. The patients complained about minimal posit operative discomfort and had good cicatrix evolution. The good results achieved by this technique lead to the conclusion that CO2 laser for these types of hemangioma is an efficient and very secure method of treatment. An important aspect of our technique is the fact that using relatively low laser power we do not perform real surgery but a less aggressive alternative of treatment. ©2004 Copyright SPIE - The International Society for Optical Engineering.2973189196S. L. Robbins, R. S. Cotran and V. Kumar, Patologia estrutural e Funciona, p. 521,Editora Guanabara, Rio de Janeiro, U, Brazil (in Portugese), 1991Crockett, D.M., McGill, T.J.I., Healy, G.B., Friedman, E.M., Benign Lesions of the Nose Cavity, and Oropharynx in Children: Excision by Carbon Dioxide Laser (1985) Ann Otol Rhinol Laringol, 94, pp. 489-493David, L.M., Zeitels, S., Neodymium - YAG Laser Photocoagulation of Hemangiomas of the Head and Neck (1987) Laryngoscope, 97, pp. 323-330D. B. Hawkins, D. M. Crockett, E. J. Kahlstrom and E. F. MacLaughlin, Corticosteroid Management of Airway Hemanfiomas: long term follow-up, Laryngoscope, 94, 00. 633-637, 1984Suen, J.Y., Waner, M., Treatment of Oral Cavity Vascular Malformations Using the Neodymiom-YAG Laser (1989) Arch Otolaryngol Head Neck Surg, 115, pp. 1329-1333Abd-El-Raheem, T.A., Hohenleutner, U., Braun-Falco, O., Landthaler, M., eruptive Satellite Angiomas of the Oral Mucosa (1994) Acta Derm Venereol, 74, pp. 72-76Lenz, H., Eichler, J., The Effect of the Argon Laser on Vessels, the Macro and Microcirculation of the Mucosa of the Hamster Cheek-Pouch. An Intravitalmicroscopic study (1975) Laryngol- Rhinol-Otol-Stuttg, 54 (7), pp. 612-619Apfelberg, D.B., Intralesional Laser Photocoagulation-Steroids as an Adjunct to Surgery for Massive Hemangiomas and Vascular Malformations (1995) Ann-Plast-Surg, 35 (2), pp. 144-148Apfelberg, D.B., Maser, M.R., Lash, H., White, D.N., Benefits ofthe Co2 Laser in Oral Hemangioma Excision (1985) Plastic and Reconstructive Surgery, 75 (1), pp. 46-50Kaplan, I., Ger, R., Sharon, U., The Carbon Dioxide Laser in Plastic Surgery (1973) Br. J. Plast. Surg, 26, p. 359Ohshiro, T., The Co2 Laser in the Treatment of Cavernous Hemangioma of the Lower Lip: A case report (1981) Lasers-Surg-Med, 1 (4), pp. 337-345Nicola, E.M.D., Coutinho, A.A., Nicola, J.H., Gusmão, R.J., Symptomatic Hemangioma of Oral Cavity Treated with CO2 Laser (1995) Proceedings of SPIE'95, 2395, pp. 189-195Actis, A., Juri, H., Gendelman, H., Oral Hemangiomas Treated with Nd:YAG and CO2 Laser (1993) Journal of Clinical Laser Medicine & Surgery, 11 (2), pp. 91-9

Lingual Frenulum: Changes After Frenectomy

Purpose: To describe the changes after frenectomy concerning mobility and functions of the tongue. Methods: Participants were 53 subjects who had never undergone speech therapy or lingual frenulum surgery. A specific lingual frenulum protocol with scores was used by speech-language pathologists when there was evidence of frenulum alteration. Ten subjects had abnormal frenulum and were referred to an otolaryngologist for frenectomy. After surgery, the subjects were re-evaluated using the same protocol. Photos and videos were taken for comparison. Results: Thirty days after surgery, the subjects had the shape of the tip of the tongue and its movements improved. Lip closure and speech were also improved. Conclusion: Frenectomy is efficient to improve tongue posture, tongue mobility, oral functions, and oral communication.244409412Suter, V.G.A., Ankyloglossia: facts and myths in diagnosis and treatment (2009) J Periodontol, 80 (8), pp. 1204-1219Hooda, A., Rathee, M., Yaday, S., Gulia, J., Ankyloglossia: a review of current status (2010) The Internet Journal of Otorhinolaryngology, 12 (2)Johnson, P.R.V., Tongue-tie - exploding the myths (2006) Infant, 2 (3), pp. 96-99Lee, H.J., Park, H.S., Park, B.S., Choi, J.W., Koo, S.K., The Improvement of tongue mobility and articulation after frenotomy in patient with ankyloglossia (2010) J Otorhinolaryngol Head Neck Surg, 53, pp. 491-496Hong, P., (2012) Ankyloglossia (tongue-tie), , Published ahead of print October 15. DOI:10.1503/cmaj.120785Marchesan, I.Q., Protocolo de avaliação do frênulo da lingual (2010) Rev CEFAC, 12 (6), pp. 977-989Darshan, H.E., Pavithra, P.M., Tongue tie: from confusion to clarity - a review (2011) Int J Den Clin, 3 (1), pp. 48-51Braga, L.A.S., Silva, J., Pantuzzo, C.L., Motta, A.R., Prevalência de alteração no frênulo lingual e suas implicações na fala de escolares (2009) Rev CEFAC, 11 (3), pp. 378-390Oredsson, J., Törngren, A., Frenotomy in children with ankyloglossia and breast-feeding problems A simple method seems to render good results (2010) Lakartidningen, 107 (10), pp. 676-678Knox, I., Tongue tie and frenotomy in the breastfeeding newborn (2010) Neoreviews, 11, pp. 513-519Ostapiuk, B., Tongue mobility in ankyloglossia with regard to articulation (2006) Ann Acad Med Stetin, 52 (3), pp. 37-47Marchesan, I.Q., Lingual frenulum: classification and speech interference (2004) Int J Orofacial Myology, 30, pp. 31-38Chaubal, T.V., Dixit, M.B., Ankyloglossia and its management (2011) J Indian Soc Periodontol, 15 (3), pp. 270-27

Tonsillar Lymphoma In Children With Unilateral Tonsillar Enlargement [linfoma Tonsilar Em Crianças Com Assimetria Tonsilar]

Objective: To demonstrate the importance of a medical examination with emphasis on changes of the palatine tonsils (PT) and proper anamnesis to early identify patients with tonsillar lymphoma. Case description: Case 1 - 5-year-old girl with a muffled voice noted by her mother and a report of "feeling a strange sensation in the throat" for two weeks. She was previously treated in another service at the beginning of the symptoms with amoxicillin without improvement. An important increase in the right PT was noted, with smooth surface and absence of crypts. The diagnosis of non-Hodgkin lymphoma (NHL) was confirmed after surgery. On further investigation, positive mesenteric lymph nodes were noted. Case 2 - 11-year-old girl came to the emergency service to investigate a painless nodule in the left palatine tonsil with progressive growth for one year, without other complaints. She had previously undergone other medical consultations, but no importance was given to the patient's complaint. Oroscopy showed that the left PT was increased crossing the midline and with a nodule in the upper pole. Patient also had NHL. Comments: A detailed examination of the oral cavity and neck is essential to identify suspicious tonsillar lymphoma. Patients with unilateral tonsillar enlargement and other findings suggestive of malignancy should undergo tonsillectomy.302288291Cinar, F., Significance of asymptomatic tonsil asymmetry (2004) Otolaryngol Head Neck Surg, 131, pp. 101-103Berkowitz, R.G., Mahadevan, M., Unilateral tonsillar enlargement and tonsillar lymphoma in children (1999) Ann Otol Rhinol Laryngol, 108, pp. 876-879Sengupta, S., Pal, R., Clinicopathological correlates of pediatric head and neck cancer (2009) J Cancer Res Ther, 5, pp. 181-185Mohammadianpanah, M., Omidvai, S., Mosalei, A., Ahmadloo, N., Treatment results of tonsillar lymphoma: A 10-year experience (2005) Ann Hemato, 84, pp. 223-226Gianvecchio, R.P., Tan, D.M., Yamamoto, E., Rodrigues, F.C., Cunha, G.A., Baldelin, C.G., Burkitt's lymphoma in child with aids (2003) Rev Paul Pediatr, 21, pp. 99-103Brodsky, L., Poje, C.P., Tonsilite, tonsilectomia e adenoidectomia (2009) Otorrinolaringologia: Cirurgia De Cabeça E Pescoço, pp. 161-164. , In: Bailey BJ, Johnson JT, editors, 4 th ed. Philadelphia: Lippincott Williams &ampWilkinsSturn-O'Brien, A.K., Hicks, J.M., Giannoni, C.M., Sulek, M., Friedman, E.M., Optimal utilization of histopathologic analysis of tonsil and adenoid specimens in the pediatric population (2010) Int J Pediatr Otorhinolaryngol, 74, pp. 161-163Tobias, G.S., Palomar, A.V., Borràs, P.M., Pérez, H.I., Ruiz, G.A., Palomar, G.V., Clinical significance of unilateral tonsillar enlargement (2009) Acta Otorrinolaringol Esp, 60, pp. 194-198Ballin, A.C., Koerner, H.N., Ballin, C.H., Pereira, R., Alcântara, L.J., Taques, G.R., Palatine tonsils asymmetry: 10 years experience of the Otorhinolaryngology service of the clinical hospital of the Federal University of Paraná (2011) Arq Int Otorrinolaringol, 15, pp. 67-71Broughton, S., McClay, J.E., Murray, A., Timmons, C., Sommeraurer, J., Andrews, W., The effectiveness of tonsillectomy in diagnosing lymphoproliferative disease in pediatric patients after liver transplantation (2000) Arch Otolaryngol Head Neck Surg, 126, pp. 1444-1447Qi, J., Fan, X., Wang, C., Ma, J., Tang, H., Unilateral tonsillar enlargement and malignant tonsillar lymphoma (2002) Lin Chuang Er Bi Yan Hou Ke Za Zhi, 16, pp. 469-470Dolev, Y., Daniel, S.J., The presence of unilateral tonsillar enlargement in patients diagnosed with palatine tonsil lymphoma: Experience at a tertiary care pediatric hospital (2008) Int J Pediatr Otorhinolaryngol, 72, pp. 9-1

Association Between Unilateral Tonsillar Enlargement And Lymphoma In Children: A Systematic Review And Meta-analysis

Lymphoma is the most common head and neck malignancy in children, and palatine tonsils asymmetry is the most frequent clinical manifestation of tonsillar lymphoma. However, several studies with children with tonsillar asymmetry found no case of lymphoma, showing that the relationship of tonsillar asymmetry with lymphoma is unclear. In this review, we aimed to identify the association between tonsillar asymmetry and tonsillar lymphoma in children by conducting systematic reviews of the literature on children with palatine tonsil lymphoma and tonsillar asymmetry. Articles comprising the paediatric age group (up to 18 years) with information concerning clinical manifestations of tonsillar lymphoma or the diagnosis of the tonsillar asymmetry were included. The main cause of asymmetry of palatine tonsils was lymphoid hyperplasia, followed by lymphoma and nonspecific benign changes. The asymmetry of tonsils was present in 73.2% of cases of lymphoma. There was an association between asymmetric palatine tonsils and lymphoma, with a likelihood ratio of 43.5 for children with asymmetry of palatine tonsils and 8938.4 for children with asymmetry of tonsils and other signs of suspicion for malignancy. We also provide recommendations on the management of suspicious cases of palatine tonsil lymphoma.933304311Kaatsch, P., Epidemiology of childhood cancer (2010) Cancer Treat Rev, 36, pp. 277-285Sengupta, S., Pal, R., Clinico pathological correlates of pediatric head and neck cancer (2009) J Cancer Res Ther, 5 (3), pp. 181-185Mohammadianpanah, M., Omidvai, S., Mosalei, A., Treatment results of tonsillar lymphoma: a 10-year experience (2005) Ann Hematol, 84, pp. 223-226Guimarães, A.C., de Carvalho, G.M., Bento, L.R., Correa, C., Gusmão, R.J., Clinical manifestations in children with tonsillar lymphoma: a systematic review (2014) Crit Rev Oncol Hematol, 90 (2), pp. 146-151Urquhart, A., Berg, R., Hodgkin's and non-Hodgkin's lymphoma of the head and neck (2001) Laryngoscope, 111 (9), pp. 1565-1569Mohammadianpanah, M., Daneshbod, Y., Ramzi, M., Primary tonsillar lymphomas according to the new World Health Organization classification: to report 87 cases and literature review and analysis (2010) Ann Hematol, 89 (10), pp. 993-1001Vega, F., Lin, P., Medeiros, L.J., Extranodal lymphomas of the head and neck (2005) Ann Diagn Pathol, 9 (6), pp. 340-350Gao, Y., Li, Y., Yuan, Z., Prognostic factors in patients with primary non-Hodgkin's lymphoma of the tonsil (2002) Zhonghua Zhong Liu Za Zhi, 24 (5), pp. 483-485Harley, E.H., Asymmetric tonsil size in children (2002) Arch Otolaryngol Head Neck Surg, 128 (7), pp. 767-769van Lierop, A.C., Prescott, C.A., Fagan, J.J., Sinclair-Smith, C.C., Is diagnostic tonsillectomy indicated in all children with asymmetrically enlarged tonsils? (2007) S Afr Med J, 97 (5), pp. 367-370Cinar, F., Significance of asymptomatic tonsil asymmetry (2004) Otolaryngol Head Neck Surg, 131 (1), pp. 101-103Berkowitz, R.G., Mahadevan, M., Unilateral tonsillar enlargement and tonsillar lymphoma in children (1999) Ann Otol Rhinol Laryngol, 108, pp. 876-879Spinou, E., Kubba, H., Konstantinidis, I., Tonsillectomy for biopsy in children with unilateral tonsillar enlargement (2002) Int J Pediatr Otorhinolaryngol, 63, pp. 15-17Akcay, A., Kara, C.O., Dagdeviren, E., Zencir, M., Variation in tonsil size in 4- to 17-year-old schoolchildren (2006) J Otolaryngol, 35 (4), pp. 270-274Liberati, A., Altman, D.G., Tetzlaff, J., The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration (2009) BMJ, 339, p. b2700Amit, S., Purwar, N., Agarwal, A., Lalchandani, D., Tonsillar follicular lymphoma in a child (2012) BMJ Case Rep, 2012. , pii: bcr2012006848Ballin, A.C., Koerner, H.N., Ballin, C.H., Palatine tonsils asymmetry: 10 years experience of the otorhinolaryngology service of the Clinical Hospital of the Federal University of Paraná (2011) Int Arch Otorhinolaryngol, 15 (1), pp. 67-71Banthia, V., Jen, A., Kacker, A., Sporadic Burkitt's lymphoma of the head and neck in the pediatric population (2003) Int J Pediatr Otorhinolaryngol, 67 (1), pp. 59-65Booth, C.L., Wang, J., Occult hematologic malignancy in routine tonsillectomy specimens: a single institutional experience and review of the literature (2013) Am J Clin Pathol, 140 (6), pp. 807-812Broughton, S., McClay, J.E., Murray, A., The effectiveness of tonsillectomy in diagnosing lymphoproliferative disease in pediatric patients after liver transplantation (2000) Arch Otolaryngol Head Neck Surg, 126 (12), pp. 1444-1447Cianci, P., Tono, V., Sala, A., A boy with Burkitt lymphoma associated with Noonan syndrome due to a mutation in RAF1 (2013) Am J Med Genet A, 161 A (6), pp. 1401-1404Dolev, Y., Daniel, S.J., The presence of unilateral tonsillar enlargement in patients diagnosed with palatine tonsil lymphoma: experience at a tertiary care pediatric hospital (2008) Int J Pediatr Otorhinolaryngol, 72 (1), pp. 9-12Garavello, W., Romagnoli, M., Sordo, L., Incidence of unexpected malignancies in routine tonsillectomy specimens in children (2004) Laryngoscope, 114, pp. 1103-1105García-Ortega, F.P., BonnínOtal, J., Durán, R., Carreño Villarreal, M., AlemánLópez, O., MalluguizaCalvo, J.R., Burkitt lymphoma of a palatine tonsil (1999) Acta Otorrinolaringol Esp, 50 (7), pp. 579-582Gheorghe, G., Albano, E.A., Porter, C.C., Posttransplant Hodgkin lymphoma preceded by polymorphic posttransplant lymphoproliferative disorder: report of a pediatric case and review of the literature (2007) J Pediatr Hematol Oncol, 29 (2), pp. 112-116Guimarães, A.C., Carvalho, G.M., Gusmão, R.J., Linfoma tonsilar em crianças com assimetria tonsilar (2012) Rev Paul Pediatr, 30 (2), pp. 288-291Kraus, M.D., Crawford, D.F., Kaleem, Z., Shenoy, S., MacArthur, C.A., Longtine, J.A., T gamma/delta hepatosplenic lymphoma in a heart transplant patient after an Epstein-Barr virus positive lymphoproliferative disorder: a case report (1998) Cancer, 82 (5), pp. 983-992Meirelles, R.C., Figueiredo, F.A., Vidal, A.R.C., Casali, A.R., Atherino, C.C.T., Burkitt's lymphoma with initial tonsil involvement: report of two cases (1998) Rev Bras Otorrinolaringol, 64 (1), pp. 62-66Oluwasanmi, A.F., Wood, S.J., Baldwin, D.L., Sipaul, F., Malignancy in asymmetrical but otherwise normal palatine tonsils (2006) Ear Nose Throat J, 85 (10), pp. 661-663Papoiliakos, S., Karkos, P.D., Korres, G., Comparison of clinical and histopathological evaluation of tonsils in pediatric and adult patients (2009) Eur Arch Otorhinolaryngol, 266, pp. 1309-1313Pellier, I., N'Golet, L., Rachieru, P., Disseminated nasal-type natural killer/T-cell lymphoma in a child: a case report (2009) J Pediatr Hematol Oncol, 31 (5), pp. 362-366Prim Espada, M.P., Diego Sastre, J.I., Hardisson Hernáez, D., Lymphoproliferative disorders of Waldeyer's ring (2002) An Esp Pediatr, 57 (4), pp. 317-320Sahni, J.K., Kumar, S., Wadhwa, V., Kathuria, G., Proteus syndrome with huge tonsillar mass causing dysphagia: a rare case (2006) J Laryngol Otol, 120 (5), pp. 408-410Sayed, H., Van Savell, H., Hutchison, R.E., Review of tonsillar lymphoma in pediatric patients from the pediatric oncology group: what can be learned about some indications for microscopic examination? (2005) Pediatr Dev Pathol, 8 (5), pp. 533-540Smitheringale, A., Lymphomas presenting in Waldeyer's ring (2000) J Otolaryngol, 29 (3), pp. 183-185Tewfik, T.L., Bond, M., al-Ghamdi, K., Bernard, C., Burkitt's lymphoma of the tonsil in children (1996) J Otolaryngol, 25 (3), pp. 205-208Koral, K., Margraf, L., Deskin, R., Management of intratonsillar abscess in children (2013) Pediatr Int, 55 (4), pp. 455-460Williams, M.D., Brown, H.M., The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger (2003) Hum Pathol, 34, pp. 1053-1057Yadav, S.P., Chanda, R., Gathwala, G., Yadav, R.K., Actinomycosis of tonsil masquerading as tumour in a 12-year old child (2002) Int J Pediatr Otorhinolaryngol, 63, pp. 73-75Zeglaoui, I., Belcadhi, M., Sriha, B., Bouzouita, K., NasalNK/T-cell lymphoma in the paediatric population. Two case reports (2009) B-ENT, 5 (2), pp. 119-123Brodsky, L., Modern assessment of tonsils and adenoids (1989) Pediatr Clin North Am, 36, pp. 1551-1569Friedman, M., Tanyeri, H., Caldarelli, D., Clinical predictors of obstructive sleep apnea (1999) Laryngoscope, 109, pp. 1901-1907Stengel, D., Bauwens, K., Sehouli, J., Ekkernkamp, A., Porzsolt, F., A likelihood ratio approach to meta-analysis of diagnostic studies (2003) J Med Screen, 10 (1), pp. 47-51Randall, D.A., Martin, P.J., Thompson, L.D.R., Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy (2007) Laryngoscope, 117, pp. 1600-160

Clinical Manifestations In Children With Tonsillar Lymphoma: A Systematic Review

Background: The lymphoma is the most common childhood malignancy in the head and neck. Approximately 15% of head and neck lymphomas in children affect the Waldeyer's ring. Early diagnosis and treatment are of great importance in the prognosis of tonsillar lymphoma patients. Objectives: To realize a systematic review of the literature on the clinical manifestations present at diagnosis of tonsillar lymphoma in pediatric patients. Date Source: Articles in English, Spanish or Portuguese in the last 15 years about lymphoma in palatine tonsil in children from PubMed/Medline, LILACS, IBECS, Cochrane, SCIELO, BIREME and Scopus. Study eligibility criteria: It was included articles and case reports that covered the pediatric age group, up to 18 years old and that contained information of the clinical manifestations of tonsillar lymphoma at diagnosis. Results: We found 87 articles of which 18 were included; there were 66 cases of lymphoma of palatine tonsils. The most common clinical manifestations found in children with lymphoma in palatine tonsils were unilateral tonsillar enlargement (72.7%), alteration in appearance of the tonsil (45.4%) and cervical lymphadenopathy (30.3%). The presence of B symptoms occurred in only 16% of the patients. Burkitt was the most common type of lymphoma found. Conclusion: The most common clinical manifestations of lymphoma in palatine tonsil are the tonsils asymmetry, alteration in the appearance of the mucous and cervical lymphadenopathy. A detailed description of cases of lymphoma in palatine tonsils and the use of criteria for classification of tonsillar asymmetry are important for future revisions. © 2013 Elsevier Ireland Ltd.902146151Kaatsch, P., Epidemiology of childhood cancer (2010) Cancer Treat Rev, 36 (4), pp. 277-285Sengupta, S., Pal, R., Clinico pathological correlates of pediatric head and neck cancer (2009) J Cancer Res Ther, 5 (3), pp. 181-185Mohammadianpanah, M., Omidvai, S., Mosalei, A., Treatment results of tonsillar lymphoma: a 10-year experience (2005) Ann Hematol, 84, pp. 223-226Urquhart, A., Berg, R., Hodgkin's and non-Hodgkin's lymphoma of the head and neck (2001) Laryngoscope, 111 (9), pp. 1565-1569Hung-Sheng, C., Ka-Wo, L., Feng-Yu, C., Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis (2012) Kaohsiung J Med Sci, pp. 1-7Yuen, A., Jacobs, C., Lymphomas of the head and neck (1999) Semin Oncol, 26, pp. 338-345Roh, J.L., Huh, J., Moon, H.N., Lymphomas of the head and neck in the pediatric population (2007) Int J Pediatr Otorhinolaryngol, 71, pp. 1471-1477Aloulou, S., Farhat, H., Bosq, J., Hodgkin's disease primarily involving the oropharynx: case report and review of the literature (2002) Hematol J, 3, pp. 164-167Mohammadianpanah, M., Daneshbod, Y., Ramzi, M., Primary tonsillar lymphomas according to the new World Health Organization classification: to report 87 cases and literature review and analysis (2010) Ann Hematol, 89 (10), pp. 993-1001Vega, F., Lin, P., Medeiros, L.J., Extranodal lymphomas of the head and neck (2005) Ann Diagn Pathol, 9 (6), pp. 340-350Gao, Y., Li, Y., Yuan, Z., Prognostic factors in patients with primary non-Hodgkin's lymphoma of the tonsil (2002) Zhonghua Zhong Liu Za Zhi, 24 (5), pp. 483-485Tewfik, T.L., Bond, M., al-Ghamdi, K., Bernard, C., Burkitt's lymphoma of the tonsil in children (1996) J Otolaryngol, 25 (3), pp. 205-208Berkowitz, R.G., Mahadevan, M., Unilateral tonsillar enlargement and tonsillar lymphoma in children (1999) Ann Otol Rhinol Laryngol, 108, pp. 876-879García-Ortega, F.P., Bonnínotal, J., Durán, R., Carreño Villarreal, M., AlemánLópez, O., MalluguizaCalvo, J.R., Burkitt lymphoma of a palatine tonsil (1999) Acta Otorrinolaringol Esp, 50 (7), pp. 579-582Broughton, S., McClay, J.E., Murray, A., The effectiveness of tonsillectomy in diagnosing lymphoproliferative disease in pediatric patients after liver transplantation (2000) Arch Otolaryngol Head Neck Surg, 126 (12), pp. 1444-1447Smitheringale, A., Lymphomas presenting in Waldeyer's ring (2000) J Otolaryngol, 29 (3), pp. 183-185Maitra, A., McKenna, R.W., Weinberg, A.G., Schneider, N.R., Kroft, S.H., Precursor B-cell lymphoblastic lymphoma. A study of nine cases lacking blood and bone marrow involvement and review of the literature (2001) Am J Clin Pathol, 115 (6), pp. 868-875Banthia, V., Jen, A., Kacker, A., Sporadic Burkitt's lymphoma of the head and neck in the pediatric population (2003) Int J Pediatr Otorhinolaryngol, 67 (1), pp. 59-65Carvalho, M.R.M.S., Carlesse, A.A., Giancoli, S.M., Diniz, F.L., Younes, E.A., Alves, M.T.S., A case report of lymphoma non-Hodgkin in tonsil- a rare disease in topography and age onset (2003) International Congress Series, 1240, pp. 689-692Williams, M.D., Brown, H.M., The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger (2003) Hum Pathol, 34, pp. 1053-1057Garavello, W., Romagnoli, M., Sordo, L., Incidence of unexpected malignancies in routine tonsillectomy specimens in children (2004) Laryngoscope, 114, pp. 1103-1105Sayed, H., Van Savell, H., Hutchison, R.E., Review of tonsillar lymphoma in pediatric patients from the pediatric oncology group: what can be learned about some indications for microscopic examination? (2005) Pediatr Dev Pathol, 8 (5), pp. 533-540Gheorghe, G., Albano, E.A., Porter, C.C., Posttransplant Hodgkin lymphoma preceded by polymorphic posttransplant lymphoproliferative disorder: report of a pediatric case and review of the literature (2007) J Pediatr Hematol Oncol, 29 (2), pp. 112-116van Lierop, A.C., Prescott, C.A., Fagan, J.J., Sinclair-Smith, C.C., Is diagnostic tonsillectomy indicated in all children with asymmetrically enlarged tonsils? (2007) S Afr Med J, 97 (MAY 5), pp. 367-370Dolev, Y., Daniel, S.J., The presence of unilateral tonsillar enlargement in patients diagnosed with palatine tonsil lymphoma: experience at a tertiary care pediatric hospital (2008) Int J Pediatr Otorhinolaryngol, 72 (1), pp. 9-12Papoiliakos, S., Karkos, P.D., Korres, G., Comparison of clinical and histopathological evaluation of tonsils in pediatric and adult patients (2009) Eur Arch Otorhinolaryngol, 266, pp. 1309-1313Zeglaoui, I., Belcadhi, M., Sriha, B., Bouzouita, K., Nasal NK/T-cell lymphoma in the paediatric population. Two case reports (2009) B-ENT, 5 (2), pp. 119-123Sturm-O'Brien, A.K., Hicks, J.M., Giannoni, C.M., Optimal utilization of histopathologic analysis of tonsil and adenoid specimens in the pediatric population (2010) Int J Pediatr Otorhinolaryngol, 74 (2), pp. 161-163Guimarães, A.C., Carvalho, G.M., Gusmão, R.J., Linfoma tonsilar em crianças com assimetria tonsilar (2012) Rev Paul Pediatr, 30 (2), pp. 288-291Rapidis, A.D., Economidis, J., Goumas, P.D., Tumours of the head and neck in children a clinico-pathological analysis of 1,007 cases (1988) J Cranio-Max-Fac Surg, 16, pp. 279-286Dubey, S., Sengupta, S.K., Kaleh, L.K., Paediatric head and neck lymphomas in Papua New Guinea: a review and analysis of 67 cases (1998) Int J Pediatr Otorhinolaryngol, 43, pp. 235-240Brodsky, L., Modern assessment of tonsils and adenoids (1989) Pediatr Clin North Am, 36, pp. 1551-1569Friedman, M., Tanyeri, H., Caldarelli, D., Clinical predictors of obstructive sleep apnea (1999) Laryngoscope, 109, pp. 1901-1907López-Guillermo, A., Colomo, L., Jiménez, M., Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin (2005) J Clin Oncol, (12), pp. 2797-2804Economopoulos, T., Fountzilas, G., Kostourou, A., Primary extranodal non-Hodgkin's lymphoma of the head and neck in adults: a clinicopathological comparison between tonsillar and non tonsillar lymphomas (1998) Anticancer Res, 18, pp. 4655-4660Morley-Jacob, C., Gallop-Evans, E., An update on lymphoma in children and young adults (2012) Paediatr Child Health, 22 (3), pp. 92-97Gobbi, P.G., Ferreri, A.J., Ponzoni, M., Levis, A., Hodgkin lymphoma (2013) Crit Rev Oncol Hematol, 85 (FEBRUARY 2), pp. 216-237Gaini, R.M., Romagnoli, M., Sala, A., Lymphomas of head and neck in pediatric patients (2009) Int J Pediatr Otorhinolaryngol, 73 (SUPPL 1), pp. S65-S70Izarzugaza, M.I., Steliarova-Foucher, E., Martos, M.C., Non-Hodgkin's lymphoma incidence and survival in European children and adolescents (1978-1997): Report from the Automated Childhood Cancer Information System Project (2006) Eur J Cancer, 42 (13), pp. 2050-2063Auerbach, M.A., Vos, S., Czernin, J., The impact of fluorodeoxyglucose positron emission tomography in primary staging and patient management in lymphoma patients (2008) Radiol Clin N Am, 46, pp. 199-211Zhang, M.J., Jiang, J.J., Jiang, M.S., He, W., F-18 FDG PET/CT in primary tonsillar lymphoma (2010) Clin Nucl Med, 35 (9), pp. 710-712Lloyd, C., McHugh, K., The role of radiology in head and neck tumours in children (2010) Cancer Imaging, 10, pp. 49-61Tschammler, A., Ott, G., Schen, T., Seelbech-Goevel, B., Schwager, K., Hahn, D., Lymphadenopathy: differentiation of benign from malignant disease-colour Doppler US assessment of intranodal angioarchitecture (1998) Radiology, 208, pp. 117-123Robson, C.D., Imaging of head and neck neoplasms in children (2010) Pediatr Radiol, 40 (4), pp. 499-509Waśniewska, E., Szmeja, Z., Value of intraoral ultrasonography in diagnosis of tonsillar tumors (2000) Otolaryngol Pol, 54 (2), pp. 121-126Gómez, S.T., Asenjo, V.P., Perera, M.B., Hernández, I.P., Giner, A.R., García, V.P., Clinical significance of unilateral tonsillar enlargement (2009) Acta Otorrinolaringol Esp, 60 (3), pp. 194-198Knight, P.J., Hamoudi, A.B., Vassy, L.E., The diagnosis and treatment of midline neck masses in children (1983) Surgery, 93, pp. 603-611Rajasekaran, K., Krakovitz, P., Enlarged neck lymph nodes in children (2013) Pediatr Clin North Am, 60 (4), pp. 923-936Bárdi, E., Csóka, M., Garai, I., Value of FDG-PET/CT examinations in different cancers of children, focusing on lymphomas (2013) Pathol Oncol Res, , [Epub ahead of print

Otorhinolaryngological Findings In A Group Of Patients With Rheumatic Diseases

Introduction: Otorhinolaryngological manifestations of rheumatologic diseases represent great challenge not only to the generalistphysician but also to the ENT doctor andrheumatologist. They often represent early manifestations of an autoimmune disorder which requires prompt and aggressive immunosuppressive treatment. Auditory, nasal, laryngeal and eye symptoms can be the first manifestation of rheumatic diseases and their proper assessment helps the doctor to identify signs of disease activity. The objective of this study is to identify the ENT manifestations in patients with rheumatic diseases in a high complexity hospital, regarding facilitating an early diagnosis and treatment. Methods: We performed clinical and complete otorhinolaryngological evaluations in patients selected from the outpatient rheumatology in a standardized manner by the use of a standardized form filling during the secondhalf of 2010. Results: In the study group, systemic lupus erythematosus (SLE) patients had predominantly laryngeal manifestations, while patients with Sjögren's syndrome showed a higher prevalence of otologic manifestations. Changes in audiometric tests were found in 53% of Wegener's granulomatosis (WG) patients, 80% of relapsing polychondritis (RP), 33% of systemic lupus erythematosus (SLE) and 50% of Churg-Strauss syndrome (SCS). Regarding nasal alterations, these were found so prevalent in all conditions, especially Churg-Strauss syndrome. Discussion and conclusion: This study demonstrated that most patients treated in our hospital has the ENT signs and symptoms commonly associated in previous studies on rheumatic diseases, but further studies with a larger number of patients must be made to establish such relations. © 2014 Sociedade Brasileira de Reumatologia.543172178Riera, R., Ciconelli, R.M., Ferraz, M.B., COPCORD studies (2006) Acta Reumatol Port., 31, pp. 119-123Gonzalez-Gay, M.A., García-Porrua, C., Etiopatogenia y clasificación e las vasculitis sistémicas (2000) Manual SER de enfermedades reumáticas, pp. 349-354. , Alonso Ruiz A, Alvaro-Gracia Alvaro JM, Blanch i Rubio J et al. (Ed.) 3 ed., Madrid: Médica PanamericanaBogas, M., Afonso, M.C., Araújo, D., Non-steroidal antiinflammatory drugs and lower intestinal tract toxicity (2006) Acta Reumatol Port, 31, pp. 227-235Pereira, D.B., Amaral, J.L.A., Szajubok, J.C.M., Lima, S.M.A.L., Chahade, W.H., Otorhinolaryngologic manifestations of autoimmune rheumatic diseases (2006) Rev Bras Reumatol., 46, pp. 118-125Papadimitraki, E.D., Kyrmizakis, D.E., Kritikos, I., Boumpas, D.T., Ear-nose-throat manifestations of autoimmune rheumatic diseases (2004) Clin Exp Rheumatol., 22, pp. 485-494Oliveira, R., Banha, J., Martins, F., Paixão, E., Pereira, D., Barcelos, F., Lymphocyte ceruloplasmin and Behçet's disease (2006) Acta Reumatol Port., 31, pp. 323-329Mosiniak-Trajnowicz, K., Lis-Ritkiewicz, M., Rutkiewicz, B., Ginter, K., Polychondritis relapsans-a case report (2006) Otolaryngol. Pol., 60, pp. 951-953Carvalho, G.M., Sachietto, Z., Bertolo, M.B., Gusmão, R.J., Policondrite recidivante e dispneia (2011) Relato de caso. Rev Bras Clin Med., 9, pp. 451-454Bacciu, A., Bacciu, S., Mercante, G., Ingegnoli, F., Grosseli, C., Vaglio, A., Ear, nose and throat manifestations of Churg-Strauss syndrome (2006) Acta Otolaryngol., 126, pp. 503-509Ruckenstein, M.J., Prasthoffer, A., Begelow, D.C., Von Feldt, J.M., Kalasinski, S.L., Immunologic and serologic testing in patients with Ménière's disease (2002) Otol. Neurotol., 23, pp. 517-520Tsunoda, K., Akaogi, J., Ohya, N., Murofushi, I., Sensorineural hearing loss as the initial manifestation of polyarteritis nodosa (2001) J. Otolaryngol., 115, pp. 311-312Hearth-Holmes, M., Baethge, B.A., Alreo, F., Wolf, R.E., Autoimmune exocrinopathy presenting as recurrent parotitis of childhood (1993) Arch. Otolaryngol Head and Neck Surgery, 119, pp. 347-349Camilleri, A.E., Swan, I.R., Murphy, E., Sturrock, R.D., Chronic otitis media: a new extra-articular manifestation in ankylosing spondylitis? (1992) Ann Rheumatol. Disease., 51, pp. 655-657Tutuncu, Z., Kavanaugh, A., Rheumatic disease in the elderly: rheumatoid arthritis (2007) Rheum Dis Clin N Am., 3, pp. 57-70Silva, C., Canhão, H., Barcelos, A., Miranda, L., Pinto, P., Santos, M.J., Protocol for evaluation and monitoring of Systemic Lupus Erythematosus (PAMLES) (2008) Acta Reumatol Port., 33, pp. 210-218Vinagre, F., Santos, M.J., da Silva, J.C., Systemic lupus erythematosus and weakness (2006) Acta Reumatol Port., 31, pp. 167-172Silva, L., Sampaio, L., Terroso, G., Almeida, G., Lucas, R., Rios, E., Amyloidosis secondary to rheumatic diseases-16 cases (2010) Acta Reumatol Port., 35, pp. 518-523Jennete, J.C., Falk, R.J., Bacon, P.A., Basu, N., Cid, M.C., Ferrario, F., Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides (2013) Arthritis Rheum., 65, pp. 1-11http://www.projetodiretrizes.org.br/projeto_diretrizes/073.pdf, Acessado em 28 de janeiro de 2011Masi, A.T., Hunder, G.G., Lie, J.T., Michel, B.A., Bloch, D.A., Arend, W.P., The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis) (1990) Arthritis Rheum., 33, pp. 1094-1100Leavitt, R.Y., Fauci, A.S., Bloch, D.A., Michel, B.A., Hunder, G.G., Arend, W.P., The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis (1990) Arthritis Rheum., 33, pp. 1101-1107Vitali, C., Bombardieri, S., Jonsson, R., Moutsopoulos, H.M., Alexander, E.L., Carsons, S.E., Classification criteria for Sjögren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group (2002) Ann Rheum Dis, 61, pp. 554-558Gergely Jr, P., Poor, G., Relapsing polychondritis (2004) Best Pract Res Clin Rheumatol, 18, pp. 723-738. , OctMourão, A.F., Oliveira, I., Pinheiro, M.N., da Graça, J.P., Stroke as the dramatic presentation of infectious endocarditis: the importance of the clinical history (2006) Acta Reumatol Port, 31, pp. 341-347Gomes, J.M., Gomes, S.M., Conde, M., Autoinflammatory syndromes (2010) Acta Reumatol Port., 35, pp. 146-154Graca, L., CTLA4Ig and the therapeutic potential of T cell costimulation blockade (2008) Acta Reumatol Port, 33, pp. 267-276Mourão, A.F., Santos, F.P., Falcão, S., Barros, R., Pinto, T.L., Mendes, A., Is the response to anti-TNFalpha treatment influenced by the presence of IgM rheumatoid factor, in Rheumatoid Arthritis patients? (2008) Acta Reumatol Port., 33, pp. 430-434Carmona, L., Ortiz, A., Abad, M.A., How good is to switch between biologics? (2007) A systematic review of the literature. Acta Reumatol Port., 32, pp. 113-128Gómez-Reino, J., Carmona, L., Recommendations to lower the risk of tuberculosis in patients treated with tumour necrosis factor alpha antagonists (2006) Acta Reumatol Port., 31, pp. 201-203George, D.L., Pradhan, S., Idiopathic sensorineural hearing disorders in adults-a pragmatic approach (2009) Nat Rev Rheumatol., 5, pp. 505-512Zeigelboim, B.S., Jurkiewicz, A.L., Palmonari, A., Alberti, A., Filho, A.R., Ferrari, K.A., Otoneurological evaluation in women with systemic lupus erythematosus: a preliminary study (2006) Arq. Int. Otorrinolaringol., 10, pp. 126-131Palombo, A.A.K., Nascimento, G.M., Filho, F.A.S., Neto, J.C., Atrofia de pregas vocais em paciente com lúpus eritematoso sistêmico: relato de caso (2010) ACTA ORL/Técnicas em Otorrinolaringologia, pp. 2879-2880Del Pero, M.M., Sivasothy, P., Vasculitis of the upper and lower airway (2009) Best Practice & Research Clinical Rheumatology., 23, pp. 403-417Rezende, C.E.B., Rodrigues, R.E.C., Yoshimura, R., Uvo, I.P., Rapoport, P.B., Granulomatose de Wegener: relato de caso (2003) Rev Bras Otorrinolaringol., 69, pp. 261-265Santos, M.J., Vinagre, F., Silva, J.J., Gil, V., Fonseca, J.E., Cardiovascular risk profile in systemic lupus erythematosus and rheumatoid arthritis: a comparative study of female patients (2010) Acta Reumatol Port, 35, pp. 325-332Conde, S.R.S.S., Marçal, A.S., Tavares, G.F., Souza, H.C.B., Vasconcelos, V.C., Complicações clínicas em pacientes portadores de lúpus eritematoso sistêmico (2009) Rev. Para. Med., 23Guimarães, V.C., Nery, G.V., Araújo, F.G.M., Barbosa, M.A., Ferreira, J.B., Clinical manifestations of Relapsing Polychondritis: case report (2008) Rev. Eletr. Enf., 10, pp. 823-827Barcelos, F., Patto, J.V., Parente, M., Medeiros, D., Sousa, M., Figueiredo, R., Applicability of syalometry and other instruments to evaluate xerostomia and xerophtalmia in a Sjögren's Syndrome outpatient clinic (2009) Acta Reumatol Port, 34, pp. 212-218Liquidato, B.M., Filho, I.B., Camargo, A.C.K., Soler, R.C., Aspectos do diagnóstico da Síndrome de Sjögren (2002) Rev. Bras. Otorrinolaringol., 68, pp. 363-367Freitas, T.M.C., Medeiros, A.M.C., Oliveira, P.T., Lima, K.C., Síndrome de Sjögren: revisão de literatura e acompanhamento de um caso clínico (2004) Rev Bras Otorrinolaringol, pp. 70283-7028

Lipoid Proteinosis And Otolaryngology [lipoproteinoses E Otorrinolaringologia]

Lipoproteinosis is an autossomal recessive disease characterized by the deposition of diffuse hyaline material in skin, mucous membranes, blood vessels and other organs. It is caused by mutations in a gene encoding a glycoprotein of the extracellular matrix (ECM1), and different mutations may lead to the distinct epithelial changes. The disease has a chronic and benign course, and the main changes observed are: skin lesions of early presentation and varied aspects, blepharosis, intracranial calcifications with neuropsychiatric manifestations, symptoms of heartburn and fullness associated with nodules around gastrointestinal tract. The main otorhinolaryngological manifestation is dysphonia, which usually begins early in life, may present irregularities on the surface of the vocal cords and thickening of the interarytenoid region. The diagnosis is made by clinic associated with the classic findings of biopsy or by mapping the gene ECM1. Treatment is directed to the signs and symptoms of the affected organs, and the main impact of the disease is in the quality of life for its esthetic and functional damage. This article proposes a review of the literature, based on detailed description of four clinical cases, focusing on otorhinolaryngological manifestations.708/SetDi, G.S., Masi, R., Cassandrini, D., Lipoid proteinosis: Case report and review of the literature (2006) Acta Otorhinolaryngol Ital, 26 (3), pp. 162-167Acar, A., Eryilmaz, A., Gocer, C., Akmansu, H., Lipoid proteinosis of larynx: Review of four cases (2004) Int J Pediatr Otorhinolaryngol, 68 (12), pp. 1557-1561Toosi, S., Ehsani, A.H., Treatment of lipoid proteinosis with acitretin: A case report (2009) Journal of European Academy of Dermatology and Venereology, 23, pp. 482-483Duke-Elder, S., MacFaul, P.A., Lipoid proteinosis (1974) The Ocular Adnexa. System of Ophthalmology, 13, pp. 310-314. , Duke-Elder S (ed), Henry Kimpton, LondonFonseca, E.C., Fendi, L.I., Andretta, P.S., Síndrome de urbach-wiethe: Relato de caso (2007) Arq Bras Oftalmol, 70 (4), pp. 689-692Blodi, F.C., Whinery, R.D., Hendricks, C.A., Lipoid-proteinosis (urbach-wiethe) involving the lids (1960) Trans Am Ophthalmol Soc, 58, pp. 155-166Baykal, C., Topkarci, Z., Yazganoglu, D., Lipoid proteinosis: A case series from istanbul (2007) International Journal of Dermatology, 46, pp. 1011-1016Bozdag, K.E., Gul, Y., Karaman, A., Lipoid proteinosis (2000) International Journal of Dermatology, 39, pp. 203-204Kumar, J., Ramesh, V., Beena, K.R., Clinicopathological cases: Case 1 (2002) Clinical and Experimental Dermatology, 27, pp. 531-532Chaudhary, S.J., Dayal, P.K., Hyalinosis cutis et mucosae. Review with a case report (1995) Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 80, pp. 168-171Hamada, T., McKean, W.H.I., Ramsay, M., Lipoid proteinosis maps to 1q21 and is caused by mutations in the extracelular matrix protein 1 gene (ECM1) (2002) Human Molecular Genetics, 11 (7), pp. 833-840Hamada, T., Wessagowit, V., South, A.P., Extracellular matrix protein 1 gene (ECM1) mutations in lipoid proteinosis and genotype-phenotype correlation (2003) The Journal of Investigative Dermatology, 120 (3), pp. 345-350Smits, P., Ni, J., Feng, P., Wauters, J., The human extracellular matrix gene 1 (ECM1): Genomic structure, cDNA cloning, expression pattern and chromosomal localization (1997) Genomics, 45, pp. 487-495Mongiat, M., Fu, J., Oldershaw, R., Perlecan protein core interacts with extracellular matrix protein 1 (ECM1), a glycoprotein involved in bone formation and angiogenesis (2003) J Biol Chem, 278, pp. 17491-17499Horev, L., Potikha, T., Ayalon, S., A novel splice-site mutation in ECM-1 gene in a consanguineous family with lipoid proteinosis (2005) Exp Dermatol, 14, pp. 891-897Chan, I., The role of extracelular matrix protein 1 in human skin (2004) Clinical and Experimental Dermatology, 29, pp. 52-56Sercu, S., Poumay, Y., Herphelin, F., Functional redundancy of extracelular matrix protein 1 in epidermal differentiation (2007) British Journal of Dermatology, 157, pp. 771-775Dyer, J.A., Yu, Q.C., Paller, A.S., Free-floating desmosomes in lipoid proteinosis: An inherent defect in keratinocyte adhesion (2006) Pediatric Dermatology, 23 (1), pp. 1-6Fujimoto, N., Terlizzi, J., Aho, S., Extracellular matrix protein 1 inhibits the activity of matrix metalloproteinase 9 through high-affinity protein/protein interactions (2006) Exp Dermatol, 15, pp. 300-307Claeys, K.G., Claes, L.R.F., Goethem, J.W.M.V., Epilepsy and migraine in a patient with urbach-wiethe disease (2007) Seizure, 16, pp. 465-468Mirancea, N., Hausser, I., Matze, D., Junctional basement membrane anomalies of skin and mucosa in lipoid proteinosis (hyalinosis cútis et mocosae) (2007) Journal of Dermatological Science, 45, pp. 175-185Mirancea, N., Hausser, I., Beck, R., Vascular anomalies in lipoid proteinosis (hyalinosis cutis et mucosae): Basement membrane componentes and ultrastructure (2006) Journal of Dermatologinal Science, 42, pp. 231-239Hu, S., Kuo, T., Hong, H., Lipoid proteinosis: Report of a possible localized formo n both hands and wrists (2005) International Journal of Dermatology, 44, pp. 408-410Uchida, T., Hayashi, H., Inaoki, M., A failure of mucocutaneous lymphangiogenesis may underlie the clinical features of lipoid proteinosis (2007) British Journal of Dermatology, 156, pp. 152-157Kowalewski, C., Kozlowska, A., Chan, I., Three-dimensional imaging reveals major changes in skin microvasculature in lipoid proteinosis and lichen sclerosus (2005) Journal of Dermatological Science, 38, pp. 215-224Holme, S.A., Lenane, P., Krafchik, B.R., What syndrome is this? (2005) Pediatric Dermatology, 22 (3), pp. 266-267Ehsani, A.H., Ghiasi, M., Robati, R.M., Lipoid proteinosis: Report of three familial cases (2005) Dermatology Online Journal, 12 (1), p. 16Kini, S., Jain, A., Shet, T.M., Lipoid proteinosis in a 12-yea-old: A report from west India (2006) Dermatology Online Journal, 12 (1), p. 10Rao, R., Prabbu, S., Sprpathi, H., (2006) Dermatology Online Journal, 14 (7), p. 16Cole, J.A., Novosel, T.A., Willians, J.V., Pocklike scarring and sublingual papules in a child (2008) Arch Dermatol, 144 (10), pp. 1383-1388Desmet, S., Devos, S.A., Hamada, T., At, Al., Clinical and Molecular Abnormal