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Biomedical subjects

Valerie B Lyon

Publications and source records attributed to Valerie B Lyon.

5 recordsLinked to original sources

Lumps and bumps in children-when to worry: recent trends in recognition and pathology of hemangiomas of infancy and Spitz nevi.

PURPOSE OF REVIEW: Hemangiomas are common, and most lesions are benign. Careful attention needs to be paid to these lesions; however, because their growth can be unpredictable, they can have important complications and can serve as markers of underlying malformations. The consequences of hemangiomas are extensive and can be challenging to recognize. RECENT FINDINGS: Recent knowledge of the pathogenesis and diagnosis of these lesions has helped raise awareness of their classification and clinical significance. Spitz nevi can also be a challenging lesion to diagnose and treat, although for different reasons. These are lesions composed of melanocytes with clinical and histopathological findings that we easily misdiagnosed and can have significant implications for patient care. SUMMARY: Both of these important lesions in infants and children are reviewed in further detail with particular attention to recent trends.

Biomarkers, Tumor↗

Necrotic facial papules in an adolescent: C2 deficiency with eventual development of lupus erythematosus.

A 14-year-old girl was admitted to the hospital because of persistent throat pain, fever, fatigue, 25 pound weight loss, and leukopenia. On physical examination she was thin, ill-appearing, and had necrotic papules on the face and palpable cervical lymph nodes. Presumptive differential diagnosis included occult malignancy and infection. Numerous investigative procedures failed to elucidate a source. Vasculitis was eventually appreciated after repeat skin biopsy. Numerous serologic studies were performed and were notable for a very low level of the second component of complement without direct evidence of lupus erythematosus (LE) or other autoimmune conditions. A diagnosis of C2 deficiency-associated vasculitis was made. She was treated with high-dose prednisone and cyclophosphamide with resolution of her symptoms. Two years later she returned with marked malar erythema. Antinuclear and Smith antibodies were then detected and a diagnosis of LE was made. She was treated with hydroxychloroquine and sun-avoidance measures with clearance of the malar rash.

Adolescent↗

Approach to procedures in neonates.

Physical constraints and metabolic differences in neonates require that special attention is given to performing procedures in this patient group. Neonates have a thinner dermis and a greater surface-to-weight ratio, allowing for easier invasion through the skin barrier. The enzymes for metabolism of agents and defense against organisms inside the body are not fully developed in infants. Very premature neonates also have less circulating albumin, making the effective concentration of circulating agent even greater. The infant is prone to unanticipated movement during procedures, such as rolling on the procedure table. The neonatal period is the most common time period for malformations to become manifest on the skin, and invasion of some of these lesions can produce morbidity. These and other factors affect the choice of the type of procedure used, the timing for intervention, and the approach to intervention in this age group. This article reviews the important considerations for approaching procedures and offers suggestions for safe and effective methods of reliably producing the intended outcome.

Anesthetics, Local↗