Pain, psychiatric comorbidities, and psychosocial stressors associated with Klippel-Trenaunay Syndrome

Publication date: Available online 5 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Jamison A. Harvey, Henry Nguyen, Katelyn R. Anderson, Jennifer J. Schoch, Emily C. Bendel, David J. Driscoll, Brian A. Palmer, Megha M. Tollefson
BackgroundKlippel-Trenaunay syndrome (KTS) is characterized by the triad of capillary malformation (CM), venous malformation (VM) +/- lymphatic malformation, and limb overgrowth. Patients with KTS have lower scores in general and mental health, physical function, and quality of life than the general population.ObjectiveTo determine the prevalence of pain and psychiatric comorbidity in patients with KTS.MethodsA retrospective review of 410 patients with KTS evaluated between 1976 and 2012 was conducted to identify the presence of pain, psychiatric comorbidities, and psychosocial stressors.ResultsPain was reported by 260 patients (63.4%) and was associated with any KTS complication (p<0.0001) and VMs of the lower extremities (p=0.0008) and feet (p=0.0007). Ninety-five patients had a diagnosed psychiatric condition (23.2%), most commonly depression (15.1%) and anxiety (5.1%). Pain (p=0.0016), superficial thrombosis (p=0.0269), deep embolic/thrombotic events (p=0.0005), gastrointestinal complications (p=0.0085), genitourinary complications (p=0.0163), and CM of the hands (p=0.0040) were associated with having a psychiatric diagnosis.LimitationsRetrospective study that relied on physician detection and reporting of variables.ConclusionsPain and psychiatric conditions, particularly depression and anxiety, are common in patients with KTS. Awareness of the psychosocial impact of KTS and appropriate screening are important.

Teaser

Klippel-Trenaunay syndrome affects general and mental health, physical function, and quality of life. Pain, complications, and capillary malformation of the hands are associated with a higher risk of psychiatric illness. Patients with Klippel-Trenuanay syndrome should be screened for potential psychosocial sequelae..