Juvenile Xanthogranuloma Follow-up

  • Author: Theodore Curtis, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jan 26, 2010
 

Further Inpatient Care

  • Patients with juvenile xanthogranuloma (JXG) rarely are admitted, except for management of acute hyphema or extensive visceral involvement. Follow-up care is dictated by the clinical situation.
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Further Outpatient Care

  • Patients with known cutaneous lesions should be seen regularly and screened for the development of ocular or other noncutaneous lesions.
  • Patients with iris tumors should undergo prompt treatment.
  • Patients presenting with hyphema should be monitored closely after acute management for ocular sequelae and management of amblyopia when appropriate.
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Inpatient & Outpatient Medications

  • Patients prescribed topical or oral steroids, as well as those receiving steroid injection, should be observed for development of cataract and glaucoma, as well as tumor response.
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Complications

  • The primary complication of ocular JXG is spontaneous hyphema and its sequelae, especially glaucoma and amblyopia.
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Prognosis

  • Spontaneous regression of skin lesions is the natural course, but in ocular disease, regression has only been infrequently documented.
  • JXG is an important cause of spontaneous hyphema in childhood, the sequelae of which include secondary glaucoma and blindness.
  • Visual prognosis of iris JXG depends upon prompt diagnosis and treatment prior to intraocular hemorrhage. Once hyphema occurs, visual morbidity increases substantially.
  • In patients with other ocular or orbital involvement, prognosis varies with the extent of the disease and its response to treatment.
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Patient Education

  • Patients with cutaneous lesions should be made aware of the importance of a screening eye examination and regular follow-up care.
  • Patients with known ocular disease should undergo prompt treatment as appropriate. They should avoid any situation where ocular trauma could occur until resolution of the ocular disease is achieved.
  • Patients should be made aware of the signs and symptoms of spontaneous hyphema and seek ophthalmic attention as soon as possible if these are noted to occur.
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Contributor Information and Disclosures
Author

Theodore Curtis, MD  Assistant Professor, Department of Ophthalmology, University of Colorado; Consulting Staff, Rocky Mountain Lions Eye Institute

Theodore Curtis, MD is a member of the following medical societies: American Academy of Ophthalmology and American Association for Pediatric Ophthalmology and Strabismus

Disclosure: Nothing to disclose.

Coauthor(s)

David T Wheeler, MD  Associate Professor, Departments of Ophthalmology and Pediatrics, Oregon Health & Science University

David T Wheeler, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Gerhard W Cibis, MD  Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas, Kansas City

Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Ophthalmological Society

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

J James Rowsey, MD  Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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