Juvenile Xanthogranuloma Follow-up

Updated: Feb 07, 2017
  • Author: Bhupendra C K Patel, MD, FRCS; Chief Editor: Michael Taravella, MD  more...
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Follow-up

Further Outpatient Care

Patients with juvenile xanthogranuloma (JXG) who have 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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Further Inpatient Care

Patients with 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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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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