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Answers: 2004 series - October 19, 2004
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Lecture 11 of 50 NEXT»
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This 1-month-old Hispanic boy with suspected Sturge Weber syndrome was seem in consultation. At age 1 week, the red raised lesions on the right side of the face started to appear. The area of redness continues to increase. CT-scan of the head was obtained prior to the examination and found to be normal. The child is otherwise healthy. The family history is unremarkable.
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| 1. |
What is the first step? |
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a -- A complete ophthalmological exam should be performed. Any patient who has been seen in the eye clinic deserves a complete eye examintaion with cycloplegic refraction and dilated fundus examination regardless of the underlying problem. Each of the alternatives are valid, but the eye exam should be done first.
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| 2. |
The treatment for this condition is: |
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d -- Systemic steroid use is necessary if lesions get larger. This child has a capillary hemangioma. It is distinguished from the port wine stain via the "three dimensional" nature, the lesions crossing midline, and the lesions appearing one week after birth. The port wine stain is flat, does not cross the midline, and the child is born with the lesion, and does not change the morphology. The large size of this lesion and involvement of the skin makes surgery or steroid injection unwise. A pediatrician should be helping with monitoring this child while on steroids and should be suggesting appropriate/safe dosage.
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| 3. |
What is the most likely diagnosis: |
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c -- Capillary hemangioma |
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