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Alezzandrini Syndrome Treatment & Management

  • Author: Camila K Janniger, MD; Chief Editor: William D James, MD  more...
 
Updated: Jun 21, 2016
 

Medical Care

Medical care includes follow-up fundus examinations, visual acuity tests, and audiometry.

In cases with widespread depigmentation, treatment with psoralen plus ultraviolet A (PUVA) can be provided. However, PUVA should be used with great caution in patients with anterior uveitis because phototherapy might aggravate the ocular inflammatory disorder. As for uveitis in this syndrome, interleukin 6 therapy may be an option.[27]

Topical steroids may be tried on localized areas of vitiligo. Patients with vitiligo should use sunscreen to prevent sunburn and subsequent skin cancer. See Vitiligo for more information about medical treatment. Intravitreal bevacizumab injection has been reported.[28]

Limited experience suggests that infliximab as adjunctive therapy may be of benefit in reducing systemic corticosteroid dosage, at least in those with Vogt-Koyanagi-Harada syndrome.[29] A study comparing cyclosporine/mycophenolate mofetil and cyclosporine/azathioprine in Vogt-Koyanagi-Harada patients delineated no statistically significant difference in efficacy or safety.[30, 31]

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Consultations

Consultation with the following specialists may be needed:

  • Dermatologist
  • Ophthalmologist
  • Otolaryngologist
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Complications

A gradual loss of vision may occur. Deafness may occur. Retinal detachment is a possible complication. Patients with diabetes mellitus should be closely monitored because they have an increased risk of retinal detachment, as Hoffman and Dudley observed.[11]

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Prevention

Because Alezzandrini syndrome is a rare disease of unknown etiology, no methods of prevention are yet known.

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Long-Term Monitoring

Follow-up fundus examinations, visual acuity tests, and audiometry can be performed. These examinations may aid in the early detection of complications such as deafness and retinal detachment.

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Contributor Information and Disclosures
Author

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Ewa Koziorynska, MD Assistant Professor of Neurology, Comprehensive Epilepsy Center, State University of New York Downstate Medical Center

Ewa Koziorynska, MD is a member of the following medical societies: Sigma Xi

Disclosure: Received none from none for none.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Noah S Scheinfeld, JD, MD, FAAD Assistant Clinical Professor, Department of Dermatology, Weil Cornell Medical College; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, New York Eye and Ear Infirmary; Assistant Attending Dermatologist, New York Presbyterian Hospital; Assistant Attending Dermatologist, Lenox Hill Hospital, North Shore-LIJ Health System; Private Practice

Noah S Scheinfeld, JD, MD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Abbvie<br/>Received income in an amount equal to or greater than $250 from: Optigenex<br/>Received salary from Optigenex for employment.

References
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Gray forelock and vitiligo on the forehead in a patient with Alezzandrini syndrome.
 
 
 
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